Revista Brasileira de terapia intensiva
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Present a critical review of traumatic brain injury (TBI) in children and adolescents, focusing on severe TBI, the mortality and the factors related with poor outcome. ⋯ The factors related with better outcomes in children with severe TBI are still obscures, despite the large number of studies, large numbers of studies. Many of these factors can be avoided or correct by aggressive fluid resuscitation, surgery treatment, monitoration and adequate intensive care.
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Rev Bras Ter Intensiva · Mar 2007
[Implementation, assessment and comparison of the T-Tube and pressure-support weaning protocols applied to the intensive care unit patients who had received mechanical ventilation for more than 48 hours].
Mechanical ventilation incurs significant morbidity and mortality, weaning intensive care unit patients is highly desirable, although it is usuallyconducted in an empirical manner. Thus, this article assessed a weaning protocol implementation and compared two different methods. ⋯ Although this study didn't show any difference between the two methods applied, we could conclude that, the implementation of standardized weaning protocols can substantially decrease the patient's reintubation rate, promoting a downward trend in mortality and morbidity for these patients and shortening their hospital and intensive care units length of stay.
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The hospital environment, especially in Intensive Care Units (ICU), due to the complexity of the assistance, as well as the physical structure, the noise, the equipments and people's movement, is considered as stress generator for the patients. The aim of this study was to identify and stratify the stressful factors for patients at an ICU, in the perspective of the own patient, relatives and health care professionals. ⋯ The perception of the main stressful factors was different among the three groups. The identification of these factors is important to the implementation of changes that can make the humanization of the ICU environment easier.
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Rev Bras Ter Intensiva · Mar 2007
[Low-doses dobutamine and fluids in high-risk surgical patients: effects on tissue oxygenation, inflammatory response and morbidity].
Dobutamine is an inotropic agent with predominant beta1- adrenergic properties frequently used to increase blood flow in critically ill patients. Dobutamine may have a role in increasing splanchnic perfusion, thereby protecting this area from further injury. We investigated the effects of low doses dobutamine (5 mug/kg/min) on tissue oxygenation, inflammatory response and postoperative complications in high-risk surgical patients. ⋯ Low-doses dobutamine and fluids after surgical trauma has no effects on the prevalence of postoperative complications in high-risk surgical patients.
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Rev Bras Ter Intensiva · Dec 2006
[Red blood cell transfusion in children admitted in a pediatric intensive care unit].
Indications of red blood cell transfusion in critically ill children are not very well determined. This study aims to describe red blood cells transfusion practice at the PICU of UNESP-Botucatu Medical School. ⋯ red blood cells transfusion is carefully prescribed at the PICU by using restrictive indications (Hb between 7 and 10 g/dL). Not always is possible to find out records of the Hb levels immediately before transfusion. Hence, a protocol to better prescribe red blood cell transfusion at the PICU was adopted.