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You searched for:"Rodrigo Della Méa Plentz"

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  • Original Article

    Influence of obesity on mortality, mechanical ventilation time and mobility of critical patients with COVID-19

    Crit Care Sci. 2024;36:e20240253en

    Abstract

    Original Article

    Influence of obesity on mortality, mechanical ventilation time and mobility of critical patients with COVID-19

    Crit Care Sci. 2024;36:e20240253en

    DOI 10.62675/2965-2774.20240253-en

    Views52

    ABSTRACT

    Objective

    To identify the influence of obesity on mortality, time to weaning from mechanical ventilation and mobility at intensive care unit discharge in patients with COVID-19.

    Methods

    This retrospective cohort study was carried out between March and August 2020. All adult patients admitted to the intensive care unit in need of ventilatory support and confirmed to have COVID-19 were included. The outcomes included mortality, time on mechanical ventilation, and mobility at intensive care unit discharge.

    Results

    Four hundred and twenty-nine patients were included, 36.6% of whom were overweight and 43.8% of whom were obese. Compared with normal body mass index patients, overweight and obese patients had lower mortality (p = 0.002) and longer intensive care unit survival (log-rank p < 0.001). Compared with patients with a normal body mass index, overweight patients had a 36% lower risk of death (p = 0.04), while patients with obesity presented a 23% lower risk (p < 0.001). There was no association between obesity and time on mechanical ventilation. The level of mobility at intensive care unit discharge did not differ between groups and showed a moderate inverse correlation with length of stay in the intensive care unit (r = -0.461; p < 0.001).

    Conclusion

    Overweight and obese patients had lower mortality and higher intensive care unit survival rates. The duration of mechanical ventilation and mobility level at intensive care unit discharge did not differ between the groups.

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    Influence of obesity on mortality, mechanical ventilation time and mobility of critical patients with COVID-19
  • Review Article

    Safety and potential benefits of physical therapy in adult patients on extracorporeal membrane oxygenation support: a systematic review

    Rev Bras Ter Intensiva. 2019;31(2):227-239

    Abstract

    Review Article

    Safety and potential benefits of physical therapy in adult patients on extracorporeal membrane oxygenation support: a systematic review

    Rev Bras Ter Intensiva. 2019;31(2):227-239

    DOI 10.5935/0103-507X.20190017

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    Abstract

    Scientific and technological advances, coupled with the work of multidisciplinary teams in intensive care units, have increased the survival of critically ill patients. An essential life support resource used in intensive care is extracorporeal membrane oxygenation. Despite the increased number of studies involving critically ill patients, few studies to date have demonstrated the safety and benefits of physical therapy combined with extracorporeal membrane oxygenation support. This review identified the clinical outcomes of physical therapy in adult patients on extracorporeal membrane oxygenation support by searching the MEDLINE®, PEDro, Cochrane CENTRAL, LILACS, and EMBASE databases and by manually searching the references of the articles published until September 2017. The database search retrieved 1,213 studies. Of these studies, 20 were included in this review, with data on 317 subjects (58 in the control group). Twelve studies reported that there were no complications during physical therapy. Cannula fracture during ambulation (one case), thrombus in the return cannula (one case), and leg swelling (one case) were reported in two studies, and desaturation and mild vertigo were reported in two studies. In contrast, improvements in respiratory/pulmonary function, functional capacity, muscle strength (with reduced muscle mass loss), incidence of myopathy, length of hospitalization, and mortality in patients who underwent physical therapy were reported. The analysis of the available data indicates that physical therapy, including early progressive mobilization, standing, ambulation, and breathing techniques, together with extracorporeal membrane oxygenation, is feasible, relatively safe, and potentially beneficial for critically ill adult patients.

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    Safety and potential benefits of physical therapy in adult patients on extracorporeal membrane oxygenation support: a systematic review

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