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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

    Early mobilization protocols for critically ill pediatric patients: systematic review

    Rev Bras Ter Intensiva. 2019;31(2):248-257

    Abstract

    Review Article

    Early mobilization protocols for critically ill pediatric patients: systematic review

    Rev Bras Ter Intensiva. 2019;31(2):248-257

    DOI 10.5935/0103-507X.20190038

    Views4

    ABSTRACT

    Objective:

    To describe the existing early mobilization protocols in pediatric intensive care units.

    Methods:

    A systematic literature review was performed using the databases MEDLINE®, Embase, SciELO, LILACS and PeDRO, without restrictions of date and language. Observational and randomized and nonrandomized clinical trials that described an early mobilization program in patients aged between 29 days and 18 years admitted to the pediatric intensive care unit were included. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale, Methodological Index for Non-Randomized Studies and the Cochrane Collaboration.

    Results:

    A total of 8,663 studies were identified, of which 6 were included in this review. Three studies described the implementation of an early mobilization program, including activities such as progressive passive mobilization, positioning, and discussion of mobilization goals with the team, in addition to contraindications and interruption criteria. Cycle ergometer and virtual reality games were also used as resources for mobilization. Four studies considered the importance of the participation of the multidisciplinary team in the implementation of early mobilization protocols.

    Conclusion:

    In general, early mobilization protocols are based on individualized interventions, depending on the child's development. In addition, the use of a cycle ergometer may be feasible and safe in this population. The implementation of institutional and multidisciplinary protocols may contribute to the use of early mobilization in pediatric intensive care units; however, studies demonstrating the efficacy of such intervention are needed.

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    Early mobilization protocols for critically ill pediatric patients: systematic review

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