Abstract
Rev Bras Ter Intensiva. 2016;28(3):220-255
DOI 10.5935/0103-507X.20160049
Organ transplantation is the only alternative for many patients with terminal diseases. The increasing disproportion between the high demand for organ transplants and the low rate of transplants actually performed is worrisome. Some of the causes of this disproportion are errors in the identification of potential organ donors and in the determination of contraindications by the attending staff. Therefore, the aim of the present document is to provide guidelines for intensive care multi-professional staffs for the recognition, assessment and acceptance of potential organ donors.
Abstract
Rev Bras Ter Intensiva. 2012;24(1):6-22
DOI 10.1590/S0103-507X2012000100003
Complications from immobility in intensive care unit patients contribute to functional decline, increased healthcare costs, reduced quality of life and higher post-discharge mortality. Physical therapy focuses on promoting recovery and preserving function, and it may minimize the impact of these complications. A group of Brazilian Association of Intensive Care Medicine physical therapy experts developed this document that contains minimal physical therapy recommendations appropriate to the Brazilian real-world clinical situation. Prevention and treatment of atelectasis, procedures related to the removal of secretions and treatment of conditions related to physical deconditioning and functional decline are discussed. Equally important is the consideration that prescribing and executing activities, mobilizations and exercises are roles of the physical therapist, whose diagnosis should precede any intervention.
Abstract
Rev Bras Ter Intensiva. 2011;23(4):394-409
DOI 10.1590/S0103-507X2011000400004
Although tetanus can be prevented by appropriate immunization, accidental tetanus continues to occur frequently in underdeveloped and developing countries. Tetanus mortality rates remain high in these areas, and studies regarding the best therapy for tetanus are scarce. Because of the paucity of data on accidental tetanus and the clinical relevance of this condition, the Associação de Medicina Intensiva Brasileira (AMIB) organized a group of experts to develop these guidelines, which are based on the best available evidence for the management of tetanus in patients requiring admission to the intensive care unit. The guidelines discuss the management of tetanus patients in the intensive care unit, including the use of immunoglobulin therapy, antibiotic therapy, management of analgesics, sedation and neuromuscular blockade, management of dysautonomia and specific issues related to mechanical ventilation and physiotherapy in this population.
Abstract
Rev Bras Ter Intensiva. 2011;23(4):410-425
DOI 10.1590/S0103-507X2011000400005
Brain death (BD) alters the pathophysiology of patients and may damage the kidneys, the lungs, the heart and the liver. To obtain better quality transplant organs, intensive care physicians in charge of the maintenance of deceased donors should attentively monitor these organs. Careful hemodynamic, ventilatory and bronchial clearance management minimizes the loss of kidneys and lungs. The evaluation of cardiac function and morphology supports the transplant viability assessment of the heart. The monitoring of liver function, the management of the patient's metabolic status and the evaluation of viral serology are fundamental for organ selection by the transplant teams and for the care of the transplant recipient
Abstract
Rev Bras Ter Intensiva. 2011;23(3):255-268
DOI 10.1590/S0103-507X2011000300003
There is a relative shortage of appropriate organs available for transplantation. The appropriate diagnosis of brain death, a suitable family approach and the maintenance of the deceased donor are fundamental in addressing this issue. The intensive care physician plays a key role in the maintenance of the deceased donor, thereby reducing losses and increasing the number of successful transplants
Abstract
Rev Bras Ter Intensiva. 2011;23(3):269-282
DOI 10.1590/S0103-507X2011000300004
The role of intensive care specialists in the maintenance of deceased potential donors is not restricted to hemodynamics. Appropriate endocrine-metabolic management is fundamental to maintaining energy support and hydroelectrolytic control, which cooperate for hemodynamic stability. Hematological changes are also important, especially considering the issues caused by inappropriate transfusions. In addition, this article discusses the role of appropriate protective ventilation to prevent inflammatory responses and to provide more transplantable lungs. Finally, judicious assessment of infections and antibiotic therapy is discussed
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