You searched for:"Márcio Soares"
We found (32) results for your search.-
Patients with hematological malignancies admitted to intensive care units: new challenges for the intensivist
Rev Bras Ter Intensiva. 2015;27(3):193-195
Abstract
Patients with hematological malignancies admitted to intensive care units: new challenges for the intensivist
Rev Bras Ter Intensiva. 2015;27(3):193-195
DOI 10.5935/0103-507X.20150040
Views1Advances in treatment of cancer patients and improved understanding of pathophysiological mechanisms behind malignant diseases contribute to increased survival and, consequently, increasing needs of intensive care support for this population.() It should be highlighted that ‘cancer’ is a name generically given to a widely heterogeneous group of diseases; in comparison to solid tumors, hematological neoplasms […]See more -
Original Articles
Management of severe community-acquired pneumonia in Brazil: a secondary analysis of an international survey
Rev Bras Ter Intensiva. 2015;27(1):57-63
Abstract
Original ArticlesManagement of severe community-acquired pneumonia in Brazil: a secondary analysis of an international survey
Rev Bras Ter Intensiva. 2015;27(1):57-63
DOI 10.5935/0103-507X.20150010
Views0Objective:
This study aimed to evaluate Brazilian physicians’ perceptions regarding the diagnosis, severity assessment, treatment and risk stratification of severe community-acquired pneumonia patients and to compare those perceptions to current guidelines.
Methods:
We conducted a cross-sectional international anonymous survey among a convenience sample of critical care, pulmonary, emergency and internal medicine physicians from Brazil between October and December 2008. The electronic survey evaluated physicians’ attitudes towards the diagnosis, risk assessment and therapeutic interventions for patients with severe community-acquired pneumonia.
Results:
A total of 253 physicians responded to the survey, with 66% from Southeast Brazil. The majority (60%) of the responding physicians had > 10 years of medical experience. The risk assessment of severe community-acquired pneumonia was very heterogeneous, with clinical evaluation as the most frequent approach. Although blood cultures were recognized as exhibiting a poor diagnostic performance, these cultures were performed by 75% of respondents. In contrast, the presence of urinary pneumococcal and Legionella antigens was evaluated by less than 1/3 of physicians. The vast majority of physicians (95%) prescribe antibiotics according to a guideline, with the combination of a 3rd/4th generation cephalosporin plus a macrolide as the most frequent choice.
Conclusion:
This Brazilian survey identified an important gap between guidelines and clinical practice and recommends the institution of educational programs that implement evidence-based strategies for the management of severe community-acquired pneumonia.
Keywords:Antimicrobial agentsBrazilCommunity-acquired infectionsDiagnosisIntensive care unitsQuestionnairesRisk assessmentSepsisSee more -
Original Articles
Baseline acetylcholinesterase activity and serotonin plasma levels are not associated with delirium in critically ill patients
Rev Bras Ter Intensiva. 2015;27(2):170-177
Abstract
Original ArticlesBaseline acetylcholinesterase activity and serotonin plasma levels are not associated with delirium in critically ill patients
Rev Bras Ter Intensiva. 2015;27(2):170-177
DOI 10.5935/0103-507X.20150029
Views0See moreABSTRACT
Objective:
The aim of this study was to investigate whether plasma serotonin levels or acetylcholinesterase activities determined upon intensive care unit admission could predict the occurrence of acute brain dysfunction in intensive care unit patients.
Methods:
A prospective cohort study was conducted with a sample of 77 non-consecutive patients observed between May 2009 and September 2010. Delirium was determined using the Confusion Assessment Method for the Intensive Care Unit tool, and the acetylcholinesterase and serotonin measurements were determined from blood samples collected up to a maximum of 24 h after the admission of the patient to the intensive care unit.
Results:
In the present study, 38 (49.6%) patients developed delirium during their intensive care unit stays. Neither serum acetylcholinesterase activity nor serotonin level was independently associated with delirium. No significant correlations of acetylcholinesterase activity or serotonin level with delirium/coma-free days were observed, but in the patients who developed delirium, there was a strong negative correlation between the acetylcholinesterase level and the number of delirium/coma-free days, indicating that higher acetylcholinesterase levels are associated with fewer days alive without delirium or coma. No associations were found between the biomarkers and mortality.
Conclusions:
Neither serum acetylcholinesterase activity nor serotonin level was associated with delirium or acute brain dysfunction in critically ill patients. Sepsis did not modify these relationships.
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Review Articles
Antiphospholipid antibodies in critically ill patients
Rev Bras Ter Intensiva. 2014;26(2):176-182
Abstract
Review ArticlesAntiphospholipid antibodies in critically ill patients
Rev Bras Ter Intensiva. 2014;26(2):176-182
DOI 10.5935/0103-507X.20140026
Views0Antiphospholipid antibodies are responsible for a wide spectrum of clinical manifestations. Venous, arterial and microvascular thrombosis and severe catastrophic cases account for a large morbidly/mortality. Through the connection between the immune, inflammatory and hemostatic systems, it is possible that these antibodies may contribute to the development of organ dysfunction and are associated with poor short and long-term prognoses in critically ill patients. We performed a search of the PubMed/MedLine database for articles written during the period from January 2000 to February 2013 to evaluate the frequency of antiphospholipid antibodies in critically ill patients and their impact on the outcomes of these patients. Only eight original studies involving critically ill patients were found. However, the development of antiphospholipid antibodies in critically ill patients seems to be frequent, but more studies are necessary to clarify their pathogenic role and implications for clinical practice.
Keywords:Antibodies, antiphospholipidAntiphospholipid syndromeCatastrophic illnessCritical illnessIntensive care unitsMultiple organ failurePrognosisSee more -
Moving beyond the assessment of mortality and severity of diseases in critical patients: we are just getting started…
Rev Bras Ter Intensiva. 2012;24(4):318-319
Abstract
Moving beyond the assessment of mortality and severity of diseases in critical patients: we are just getting started…
Rev Bras Ter Intensiva. 2012;24(4):318-319
DOI 10.1590/S0103-507X2012000400003
Views0EDITORIAL Moving beyond the assessment of mortality and severity of diseases in critical patients: we are just getting started…[…]See more -
Editoriais
End-of-life care in Brazilian ICUs is not just a legal issue: adequate training and knowledge are essential to improve care
Rev Bras Ter Intensiva. 2011;23(4):388-390
Abstract
EditoriaisEnd-of-life care in Brazilian ICUs is not just a legal issue: adequate training and knowledge are essential to improve care
Rev Bras Ter Intensiva. 2011;23(4):388-390
DOI 10.1590/S0103-507X2011000400002
Views0EDITORIAL End-of-life care in Brazilian ICUs is not just a legal issue: adequate training and knowledge are essential to improve care […]See more -
Review Articles
Novel biomarkers in severe community-acquired pneumonia
Rev Bras Ter Intensiva. 2011;23(4):499-506
Abstract
Review ArticlesNovel biomarkers in severe community-acquired pneumonia
Rev Bras Ter Intensiva. 2011;23(4):499-506
DOI 10.1590/S0103-507X2011000400016
Views0See moreCommunity-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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Original Articles
Outcomes of cancer patients admitted to Brazilian intensive care units with severe acute kidney injury
Rev Bras Ter Intensiva. 2010;22(3):236-244
Abstract
Original ArticlesOutcomes of cancer patients admitted to Brazilian intensive care units with severe acute kidney injury
Rev Bras Ter Intensiva. 2010;22(3):236-244
DOI 10.1590/S0103-507X2010000300004
Views0See moreOBJECTIVES: Critically ill cancer patients are at increased risk for acute kidney injury, but studies on these patients are scarce and were all single centered conducted in specialized intensive care units. The objective was to evaluate the characteristics and outcomes in a prospective cohort of cancer patients admitted to several intensive care units with acute kidney injury. METHODS: Prospective multicenter cohort study conducted in intensive care units from 28 hospitals in Brazil over a two-month period. Univariate and multivariate logistic regression were used to identify factors associated with hospital mortality. RESULTS: Out of all 717 intensive care unit admissions, 87 (12%) had acute kidney injury and 36% of them received renal replacement therapy. Kidney injury developed more frequently in patients with hematological malignancies than in patients with solid tumors (26% vs. 11%, P=0.003). Ischemia/shock (76%) and sepsis (67%) were the main contributing factor for and kidney injury was multifactorial in 79% of the patients. Hospital mortality was 71%. General and renal-specific severity-of-illness scores were inaccurate in predicting outcomes for these patients. In a multivariate analysis, length of hospital stay prior to intensive care unit, acute organ dysfunctions, need for mechanical ventilation and a poor performance status were associated with increased mortality. Moreover, cancer-related characteristics were not associated with outcomes. CONCLUSIONS: The present study demonstrates that intensive care units admission and advanced life-support should be considered in selected critically ill cancer patients with kidney injury.
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis