You searched for:"Jorge Ibrain Figueira Salluh"
We found (31) results for your search.-
Original Articles
Intensive care physicians’ attitudes and perceptions on nutrition therapy: a web-based survey
Rev Bras Ter Intensiva. 2010;22(1):53-63
Abstract
Original ArticlesIntensive care physicians’ attitudes and perceptions on nutrition therapy: a web-based survey
Rev Bras Ter Intensiva. 2010;22(1):53-63
DOI 10.1590/S0103-507X2010000100010
Views0See moreOBJECTIVE: Nutritional therapy is an important element in critical ill patient care. Although recognized as specialty, multidisciplinary teams in nutrition support are scarce in our country. Possibly, nutrition support therapy is applied by intensive care physicians and this may vary. The aim of the study is describe these specialists perceptions about theirs attitudes in enteral nutrition support. METHODS: A questionnaire was elaborated in an on-line platform. After pre-validation, it was sent by electronic mail to intensivists. In 30 days answers were collected, considering only the full-filled questionnaires. RESULTS: One hundred an fourteen forms were returned, 112 were analyzed. The responders were localized at majority in southeastern region. About beggining of nutritional support, the majority of answers reflect perceptions in accord to specialists societies recommendations. The responders’ perception the frequent utilization of assistentials protocols in nutrition care. After support beginning, the responders perceptions about theirs participation in changes in therapeutic plan seems to be lower. The self-knowledge about the theme among the responders was 6.0 (arithmetic media) in a 1 to 10 scale. CONCLUSIONS: More studies are necessary to evaluate nutritional support practices among intensive care physicians. Alternatives to on-line platform should be considered. Possibly, intensive care physicians do better in the initial phases of enteral support than in continuity of care. Intensive care physicians knowledge about the issue is suboptimal.
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Review Articles
Understanding the PIRO concept: from theory to clinical practice – part 2
Rev Bras Ter Intensiva. 2010;22(1):64-68
Abstract
Review ArticlesUnderstanding the PIRO concept: from theory to clinical practice – part 2
Rev Bras Ter Intensiva. 2010;22(1):64-68
DOI 10.1590/S0103-507X2010000100011
Views0A sepsis staging system focused on predisposition, insult, host response and organ failure may provide a useful basis for risk stratification. Knowledge on interactions among predisposing factors, insult characteristics and host response might help us to improve our understanding on sepsis pathophysiology and allow more individual therapeutic approach. Recent clinical studies documented the clinical importance of PIRO approach for severity stratification in septic patients in intensive care unit, and also for specific conditions such as community acquired pneumonia and ventilator associated pneumonia , with a good performance for outcome prediction. In this review we describe how this new concept can be used in clinical practice and provide some insights on its usefulness to facilitate the stratification and potential for enrollment in clinical trials of sepsis therapies.
Keywords:Intensive careMultiple organ failureOutcome and process assessmentPrognosisRisk assessmentSepsisSee more -
Review Articles
Understanding the PIRO concept: from theory to clinical practice – Part 1
Rev Bras Ter Intensiva. 2009;21(4):425-431
Abstract
Review ArticlesUnderstanding the PIRO concept: from theory to clinical practice – Part 1
Rev Bras Ter Intensiva. 2009;21(4):425-431
DOI 10.1590/S0103-507X2009000400013
Views0Despite recent advances in diagnosis and care of critically ill patients sepsis related mortality rate remains unacceptably high. Therefore, new methods of evaluation are necessary to provide an earlier and more accurate characterization of septic patients. Based on the (oncologic) TNM system, the PIRO concept was introduced as a new staging system for sepsis in order to assess risk and predict prognosis, with potential to assist in inclusion of patients in clinical studies and estimate the probability of response of patients to specific therapeutic interventions.
Keywords:Intensive careMultiple organ failureOutcome and process assessment (Health Care)PrognosisRisk assessmentSepsisSee more -
Glucose control in critically ill patients in 2009: no alarms and no surprises
Rev Bras Ter Intensiva. 2009;21(3):310-314
Abstract
Glucose control in critically ill patients in 2009: no alarms and no surprises
Rev Bras Ter Intensiva. 2009;21(3):310-314
DOI 10.1590/S0103-507X2009000300012
Views0See moreGlucose control is a major issue in critical care since landmark publications from the last decade leading to widespread use of strict glucose control in the clinical practice. Subsequent trials showed discordant results that lead to several questions and concerns about benefits and risks of implementing an intensive glucose control protocol. In the midst of all recent controversy, we propose that a new glycemic target -150mg/dl) should be aimed. This target glucose level could offer protection against the deleterious effects of hyperglycemia and at the same time keep patient’s safety avoiding hypoglicemia. The article presents a critical review of the current literature on intensive insulin therapy in critically ill patients.
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Letters to the Editor
Drotrecogin alfa (activated) in clinical practice and current evidences: reply
Rev Bras Ter Intensiva. 2008;20(3):323-324
Abstract
Letters to the EditorDrotrecogin alfa (activated) in clinical practice and current evidences: reply
Rev Bras Ter Intensiva. 2008;20(3):323-324
DOI 10.1590/S0103-507X2008000300018
Views0LETTER TO THE EDITOR Drotrecogin alfa (activated) in clinical practice and current evidences[…]See more -
Review Articles
Drotrecogin alfa activated in clinical practice and the current evidences
Rev Bras Ter Intensiva. 2008;20(2):173-177
Abstract
Review ArticlesDrotrecogin alfa activated in clinical practice and the current evidences
Rev Bras Ter Intensiva. 2008;20(2):173-177
DOI 10.1590/S0103-507X2008000200010
Views0See moreBACKGROUND AND OBJECTIVES: The debate on efficacy and patient safety related to the use of drotrecogin alfa (DrotAA) is timely, principally due to the negative results observed in clinical studies performed after the PROWESS study, and the economic cost-related impact of the drug on the healthcare system. The aim of this study was to review the main studies on the use of DrotAA in patients with severe sepsis. The focus was on drug efficacy-and patient safety-related issues. CONTENTS: Articles were selected by a MedLine search for studies on the use of DrotAA in patients with sepsis using the following key words: activated protein C; drotrecogin alfa; sepsis; septic shock; Xigris®. Additional references were retrieved from the studies initially selected. CONCLUSIONS: Mortality and bleeding complications associated with the use of DrotAA were more frequent in large observational studies than those reported in randomized trials. In the light of the current knowledge, routine use of DrotAA should be reevaluated until well-designed confirmatory clinical trials can clarify the true efficacy and safety of the drug and help identify the subgroup of patients that can benefit from use of DrotAA. Physicians should be cautious with the rapid transfer of evidences not well-documented, to the guidelines and recommendations practiced in the care and treatment of patients with severe sepsis.
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Editorial
Relative adrenal failure and the use of steroids in sepsis: are we closer to a consensus?
Rev Bras Ter Intensiva. 2006;18(1):7-8
Abstract
EditorialRelative adrenal failure and the use of steroids in sepsis: are we closer to a consensus?
Rev Bras Ter Intensiva. 2006;18(1):7-8
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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