You searched for:"Jorge Ibrain Figueira Salluh"
We found (31) results for your search.-
Original Article
Delirium in intensive care unit patients under noninvasive ventilation: a multinational survey
Rev Bras Ter Intensiva. 2015;27(4):360-368
Abstract
Original ArticleDelirium in intensive care unit patients under noninvasive ventilation: a multinational survey
Rev Bras Ter Intensiva. 2015;27(4):360-368
DOI 10.5935/0103-507X.20150061
Views0ABSTRACT
Objective:
To conduct a multinational survey of intensive care unit professionals to determine the practices on delirium assessment and management, in addition to their perceptions and attitudes toward the evaluation and impact of delirium in patients requiring noninvasive ventilation.
Methods:
An electronic questionnaire was created to evaluate the profiles of the respondents and their related intensive care units, the systematic delirium assessment and management and the respondents’ perceptions and attitudes regarding delirium in patients requiring noninvasive ventilation. The questionnaire was distributed to the cooperative network for research of the Associação de Medicina Intensiva Brasileira (AMIB-Net) mailing list and to researchers in different centers in Latin America and Europe.
Results:
Four hundred thirty-six questionnaires were available for analysis; the majority of the questionnaires were from Brazil (61.9%), followed by Turkey (8.7%) and Italy (4.8%). Approximately 61% of the respondents reported no delirium assessment in the intensive care unit, and 31% evaluated delirium in patients under noninvasive ventilation. The Confusion Assessment Method for the intensive care unit was the most reported validated diagnostic tool (66.9%). Concerning the indication of noninvasive ventilation in patients already presenting with delirium, 16.3% of respondents never allow the use of noninvasive ventilation in this clinical context.
Conclusion:
This survey provides data that strongly reemphasizes poor efforts toward delirium assessment and management in the intensive care unit setting, especially regarding patients requiring noninvasive ventilation.
Keywords:Attitude of health personnelCritical careDeliriumDiagnostic techniques, neurologicalNoninvasive ventilationQuestionnairesSee more -
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 -
Review Articles
Perceptions and practices regarding delirium, sedation and analgesia in critically ill patients: a narrative review
Rev Bras Ter Intensiva. 2013;25(2):155-161
Abstract
Review ArticlesPerceptions and practices regarding delirium, sedation and analgesia in critically ill patients: a narrative review
Rev Bras Ter Intensiva. 2013;25(2):155-161
DOI 10.5935/0103-507X.20130027
Views0See moreA significant number of landmark studies have been published in the last decade that increase the current knowledge on sedation for critically ill patients. Therefore, many practices that were considered standard of care are now outdated. Oversedation has been shown to be hazardous, and light sedation and no-sedation protocols are associated with better patient outcomes. Delirium is increasingly recognized as a major form of acute brain dysfunction that is associated with higher mortality, longer duration of mechanical ventilation and longer lengths of stay in the intensive care unit and hospital. Despite all the available evidence, translating research into bedside care is a daunting task. International surveys have shown that practices such as sedation interruption and titration are performed only in the minority of cases. Implementing best practices is a major challenge that must also be addressed in the new guidelines. In this review, we summarize the findings of sedation and delirium research over the last years. We also discuss the gap between evidence and clinical practice and highlight ways to implement best practices at the bedside.
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Editorial
Use of biomarkers in sepsis: many questions, few answers
Rev Bras Ter Intensiva. 2013;25(1):1-2
Abstract
EditorialUse of biomarkers in sepsis: many questions, few answers
Rev Bras Ter Intensiva. 2013;25(1):1-2
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Editoriais
Prevention of delirium in critically ill patients: a new beginning?
Rev Bras Ter Intensiva. 2012;24(1):1-3
Abstract
EditoriaisPrevention of delirium in critically ill patients: a new beginning?
Rev Bras Ter Intensiva. 2012;24(1):1-3
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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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Review Articles
The importance of delirium monitoring in the intensive care unit
Rev Bras Ter Intensiva. 2010;22(3):274-279
Abstract
Review ArticlesThe importance of delirium monitoring in the intensive care unit
Rev Bras Ter Intensiva. 2010;22(3):274-279
DOI 10.1590/S0103-507X2010000300010
Views0See moreDelirium is an acute confusional state associated with increased mortality in the intensive care unit and long-term impaired functional recovery. Despite its elevated incidence and major impact in the outcomes of critically ill patients, delirium remains under-diagnosed. Presently, there are validated instruments to diagnose and monitor delirium, allowing the detection of early organ dysfunction and treatment initiation. Beyond patient’s non-modifiable risk factors, there are modifiable clinical and environmental aspects that should be accessed to reduce the occurrence and severity of delirium. As recent studies demonstrate that interventions aiming to reduce sedative exposure and to improve patients’ orientation associated with early mobility have proved to reduce delirium, a low incidence of delirium should be targeted and considered as a measure of quality of care in the intensive care unit (ICU).
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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