You searched for:"Alexandre Simões Dias"
We found (11) results for your search.-
Original Article
Comparison of bronchial hygiene techniques in mechanically ventilated patients: a randomized clinical trial
Rev Bras Ter Intensiva. 2019;31(1):39-46
Abstract
Original ArticleComparison of bronchial hygiene techniques in mechanically ventilated patients: a randomized clinical trial
Rev Bras Ter Intensiva. 2019;31(1):39-46
DOI 10.5935/0103-507X.20190005
Views1ABSTRACT
Objective:
To compare the effects of vibrocompression and hyperinflation with mechanical ventilator techniques alone and in combination (hyperinflation with mechanical ventilator + vibrocompression) on the amount of aspirated secretion and the change in hemodynamic and pulmonary parameters.
Methods:
A randomized clinical trial with critically ill patients on mechanical ventilation conducted in the intensive care unit of a university hospital. The patients were randomly allocated to receive one of the bronchial hygiene techniques for 10 minutes (vibrocompression or hyperinflation with mechanical ventilator or hyperinflation with mechanical ventilator + vibrocompression). Afterwards, the patients were again randomly allocated to receive either the previous randomly allocated technique or only tracheal aspiration. The weight of aspirated secretions (in grams), ventilatory mechanics and cardiopulmonary data before and after the application of the techniques were analyzed. The tracheal reintubation frequency and time and mortality on mechanical ventilation were also evaluated.
Results:
A total of 93 patients (29 vibrocompression, 32 hyperinflation with mechanical ventilator and 32 hyperinflation with mechanical ventilator + vibrocompression) on mechanical ventilation for more than 24 hours were included. The hyperinflation with mechanical ventilator + vibrocompression group was the only one that presented a significant increase in aspirated secretions compared to tracheal aspiration alone [0.7g (0.1 – 2.5g) versus 0.2g (0.0 – 0.6g), p value = 0.006].
Conclusion:
Compared to tracheal aspiration alone, the combination of hyperinflation with mechanical ventilator + vibrocompression techniques was most efficient for increasing the amount of aspirated secretions.
Keywords:Bronchoalveolar lavageHygieneInsufflationPhysical therapy modalitiesRespiratory aspirationVentilators, mechanicalSee more -
Commentaries
Neurally adjusted ventilatory assist in pediatrics: why, when, and how?
Rev Bras Ter Intensiva. 2017;29(4):408-413
Abstract
CommentariesNeurally adjusted ventilatory assist in pediatrics: why, when, and how?
Rev Bras Ter Intensiva. 2017;29(4):408-413
DOI 10.5935/0103-507X.20170064
Views0IntroductionIn pediatrics, good synchrony in controlled assisted ventilation is not always possible and may delay recovery, prolong mechanical ventilation (MV), and contribute to loss of muscle strength and increased calorie expenditure.()In controlled assisted ventilation, the trigger (drive) is a decisive factor in the release of the assisted cycle, as it is regulated by the pressure […]See more -
Original Articles
Acute bag-valve breathing maneuvers plus manual chest compression is safe during stable septic shock: a randomized clinical trial
Rev Bras Ter Intensiva. 2017;29(1):14-22
Abstract
Original ArticlesAcute bag-valve breathing maneuvers plus manual chest compression is safe during stable septic shock: a randomized clinical trial
Rev Bras Ter Intensiva. 2017;29(1):14-22
DOI 10.5935/0103-507X.20170004
Views1See moreABSTRACT
Objective:
To evaluate the effects of bag-valve breathing maneuvers combined with standard manual chest compression techniques on safety, hemodynamics and oxygenation in stable septic shock patients.
Design:
A parallel, assessor-blinded, randomized trial of two groups. A computer-generated list of random numbers was prepared by an independent researcher to allocate treatments.
Setting:
The Intensive Care Unit at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul.
Participants:
Fifty-two subjects were assessed for eligibility, and 32 were included. All included subjects (n = 32) received the allocated intervention (n = 19 for the Experimental Group and n = 13 for the Control Group).
Intervention:
Twenty minutes of bag-valve breathing maneuvers combined with manual chest compression techniques (Experimental Group) or chest compression, as routinely used at our intensive care unit (Control Group). Follow-up was performed immediately after and at 30 minutes after the intervention.
Main outcome measure:
Mean artery pressure.
Results:
All included subjects completed the trial (N = 32). We found no relevant effects on mean artery pressure (p = 0.17), heart rate (p = 0.50) or mean pulmonary artery pressure (p = 0.89) after adjusting for subject age and weight. Both groups were identical regarding oxygen consumption after the data adjustment (p = 0.84). Peripheral oxygen saturation tended to increase over time in both groups (p = 0.05), and there was no significant association between cardiac output and venous oxygen saturation (p = 0.813). No clinical deterioration was observed.
Conclusion:
A single session of bag-valve breathing maneuvers combined with manual chest compression is hemodynamically safe for stable septic-shocked subjects over the short-term.
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AUTHORS’ RESPONSE
Rev Bras Ter Intensiva. 2015;27(3):293-295
Abstract
AUTHORS’ RESPONSE
Rev Bras Ter Intensiva. 2015;27(3):293-295
DOI 10.5935/0103-507X.20150049
Views0Thank you for your compliments and the opportunity to discuss not only the practices of early mobilization and out-of-bed extubation but also the incorporation of these practices into the care of critically ill patients in our country.First, we note that the benefits of early mobilization (the mobilization of patients who have received mechanical ventilation for […]See more -
Original Articles
Adherence to the items in a bundle for the prevention of ventilator-associated pneumonia
Rev Bras Ter Intensiva. 2014;26(4):355-359
Abstract
Original ArticlesAdherence to the items in a bundle for the prevention of ventilator-associated pneumonia
Rev Bras Ter Intensiva. 2014;26(4):355-359
DOI 10.5935/0103-507X.20140054
Views0Objective:
To assess adherence to a ventilator care bundle in an intensive care unit and to determine the impact of adherence on the rates of ventilatorassociated pneumonia.
Methods:
A total of 198 beds were assessed for 60 days using a checklist that consisted of the following items: bed head elevation to 30 to 45º; position of the humidifier filter; lack of fluid in the ventilator circuit; oral hygiene; cuff pressure; and physical therapy. Next, an educational lecture was delivered, and 235 beds were assessed for the following 60 days. Data were also collected on the incidence of ventilator-acquired pneumonia.
Results:
Adherence to the following ventilator care bundle items increased: bed head elevation from 18.7% to 34.5%; lack of fluid in the ventilator circuit from 55.6% to 72.8%; oral hygiene from 48.5% to 77.8%; and cuff pressure from 29.8% to 51.5%. The incidence of ventilator-associated pneumonia was statistically similar before and after intervention (p=0.389).
Conclusion:
The educational intervention performed in this study increased the adherence to the ventilator care bundle, but the incidence of ventilator-associated pneumonia did not decrease in the small sample that was assessed.
Keywords:health educationIntensive care unitsIntervention studiesVentilator-associated pneumonia/prevention & controlSee more
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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