Abstract
Rev Bras Ter Intensiva. 2019;31(1):21-26
DOI 10.5935/0103-507X.20190007
This study sought to describe and quantify the pharmacological and nonpharmacological strategies used to relieve the pain/stress of neonates during hospitalization in neonatal intensive care units.
This quantitative, longitudinal, and descriptive study examined 50 neonates from neonatal intensive care unit admission to discharge.
A total of 9,948 painful/stressful procedures were recorded (mean = 11.25 ± 6.3) per day per neonate. A total of 11,722 pain-management and relief interventions were performed, of which 11,495 (98.1%) were nonpharmacological strategies, and 227 (1.9%) were pharmacological interventions. On average, each neonate received 235 pain-management and treatment interventions during hospitalization, 13 nonpharmacological interventions per day, and one pharmacological intervention every 2 days.
Neonates receive few specific measures for pain relief given the high number of painful and stressful procedures performed during hospitalization. Thus, it is essential to implement effective pain-relief protocols.
Abstract
Rev Bras Ter Intensiva. 2012;24(2):207-210
DOI 10.1590/S0103-507X2012000200018
The administration of surfactant via tracheal cannula with mechanical ventilation is the conventional treatment for infant respiratory distress syndrome. Hemodynamic and respiratory changes due to tracheal intubation and the need for premedication justify the search for less invasive alternatives of surfactant administration. The objective of this study was to describe the use of the ProSealTM laryngeal mask airway as an option for the treatment of respiratory distress syndrome in a premature infant born at 31 weeks of gestation, at 1335 g, with respiratory difficulty after the first hour of life and exhibiting the clinical and radiologic features of respiratory distress syndrome. The surfactant was administered with the use of the ProSealTM laryngeal mask airway at 3.5 hours of life. It was well tolerated, with no need for tracheal intubation. Normal gasometry and radiologic improvement were observed after three and six hours of administration. Oxygen administration was suspended after eight days, with no comorbidities at discharge. The laryngeal mask airway seems to be a painless and less invasive alternative to treat respiratory distress syndrome and may reduce the need for tracheal intubation and mechanical ventilation. The efficacy and advantages of this route of treatment should be confirmed in a study of an adequate sample.
Abstract
Rev Bras Ter Intensiva. 2011;23(4):499-506
DOI 10.1590/S0103-507X2011000400016
Community-acquired pneumonia (CAP) is the most common infectious disease requiring admission to intensive care units (ICUs), and achieving an early and precise diagnosis of CAP remains a challenge. Biomarkers play an important role in improving clinical judgment in the emergency room and are adjuvant in evaluating treatment responses. Novel biomarkers, such as cortisol, pro-adrenomedullin and endothelin-1, have been shown to be associated with disease severity and short-term outcomes. This review article focuses on the clinical use of novel biomarkers, severity prediction and treatment monitoring as well as future directions of the field.
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