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19 articles
  • Artigos de Revisão

    Family approach and consent for organ donation

    Rev Bras Ter Intensiva. 2007;19(1):85-89

    Abstract

    Artigos de Revisão

    Family approach and consent for organ donation

    Rev Bras Ter Intensiva. 2007;19(1):85-89

    DOI 10.1590/S0103-507X2007000100011

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    BACKGROUND AND OBJECTIVES: Since organ transplantation has become the treatment of choice for several end-stage diseases, organ shortage is the most important barrier for the procedures and waiting lists are increasing out of proportion. The objective of this study was to review the best practices concerning family referral and how these issues and others aspects of the donation process can influence consent rates. CONTENTS: Despite the growing number of live donors, the brain death donor continuous to be the major source of organs for transplantation and the only source of extra-renal organs. Many problems have been identified in the donation process, including non-identification of the brain death donor, inadequate care of the donors and family refusal to donation. Increasing the consent rate for donation seems to be a good alternative to reduce organ shortage. CONCLUSIONS: Family decision to donate organs is influenced by several aspects. Highly trained professionals in family referral can affect consent rates.

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    Family approach and consent for organ donation
  • Artigos de Revisão

    Nutritional therapy in Intensive Care Unit

    Rev Bras Ter Intensiva. 2007;19(1):90-97

    Abstract

    Artigos de Revisão

    Nutritional therapy in Intensive Care Unit

    Rev Bras Ter Intensiva. 2007;19(1):90-97

    DOI 10.1590/S0103-507X2007000100012

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    BACKGROUND AND OBJECTIVES: The purpose of this review is to approach the main necessary aspects for the accomplishment of safety and efficient nutritional therapy to the critically ill patient. CONTENTS: Bibliographical survey with didactic books and scientific articles was made in Portuguese, English and Spanish with results of the last 20 years. Nutritional support is an integrant part in the care of patients in intensive care units. The success of the nutritional therapy involves the stages of nutritional assessment, determines the route of diet infusion and the calories and nutrients needs. CONCLUSIONS: The use of nutrients with immune function (immunonutrients) is each more frequents, however, its use is not well established for critical illness. More clinical studies are necessary to establish the best form to nourish the critical ill patient.

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  • Artigos de Revisão

    Severe traumatic braininjury in children and adolescents

    Rev Bras Ter Intensiva. 2007;19(1):98-106

    Abstract

    Artigos de Revisão

    Severe traumatic braininjury in children and adolescents

    Rev Bras Ter Intensiva. 2007;19(1):98-106

    DOI 10.1590/S0103-507X2007000100013

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    BACKGROUND AND OBJECTIVES: 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. CONTENTS: It was made a systematic review in MEDLINE, SciElo e Lilacs, with the key words: traumatic brain injury, craniocerebral trauma, children and mortality. The most important articles related in the Guidelines of Brain Trauma Foundation (2000 e 2003) were selected too. TBI is one of the most important causes of mortality and morbidity in children and adolescents, and morbidity in children and adolescents. The mortality variation was between 10% and 55%, depending of the patients select criteria, trauma severity and units where the studies were made. The children mortality was, in general, lower than that found in adults and the most important factors related with an increased mortality were: Glasgow Coma Score, hypotension, cerebral swelling and lower cerebral perfusion press. Severe TBI endpoint treatment is to correct the secondary brain lesions related factors. CONCLUSIONS: 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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