You searched for:"Fernando Silva Guimarães"
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Review Article
Cough peak flow to predict extubation outcome: a systematic review and meta-analysis
Rev Bras Ter Intensiva. 2021;33(3):445-456
Abstract
Review ArticleCough peak flow to predict extubation outcome: a systematic review and meta-analysis
Rev Bras Ter Intensiva. 2021;33(3):445-456
DOI 10.5935/0103-507X.20210060
Views0See moreAbstract
Objective:
This systematic review was designed to assess the usefulness of cough peak flow to predict the extubation outcome in subjects who passed a spontaneous breathing trial.
Methods:
The search covered the scientific databases MEDLINE, Lilacs, Ibecs, Cinahl, SciELO, Cochrane, Scopus, Web of Science and gray literature. The Quality Assessment of Diagnostic Accuracy Studies was used to assess the methodological quality and risk of study bias. The statistical heterogeneity of the likelihood (LR) and diagnostic odds ratios were evaluated using forest plots and Cochran’s Q statistic, and a crosshair summary Receiver Operating Characteristic plot using the multiple cutoffs model was calculated.
Results:
We initially retrieved 3,522 references from the databases; among these, 12 studies including 1,757 subjects were selected for the qualitative analysis. Many studies presented an unclear risk of bias in the “patient selection” and “flow and time” criteria. Among the 12 included studies, seven presented “high risk” and five “unclear risk” for the item “reference standard.” The diagnostic performance of the cough peak flow for the extubation outcome was low to moderate when we considered the results from all included studies, with a +LR of 1.360 (95%CI 1.240 – 1.530), -LR of 0.218 (95%CI 0.159 – 0.293) and a diagnostic odds ratio of 6.450 (95%CI 4.490 – 9.090). A subgroup analysis including only the studies with a cutoff between 55 and 65 L/minute showed a slightly better, although still moderate, performance.
Conclusion:
A cough peak flow assessment considering a cutoff between 55 and 65L/minute may be useful as a complementary measurement prior to extubation. Additional well-designed studies are necessary to identify the best method and equipment to record the cough peak flow as well as the best cutoff.
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Original Articles
Brazilian version of the Functional Status Score for the ICU: translation and cross-cultural adaptation
Rev Bras Ter Intensiva. 2017;29(1):34-38
Abstract
Original ArticlesBrazilian version of the Functional Status Score for the ICU: translation and cross-cultural adaptation
Rev Bras Ter Intensiva. 2017;29(1):34-38
DOI 10.5935/0103-507X.20170006
Views0See moreABSTRACT
Objective:
The aim of the present study was to translate and cross-culturally adapt the Functional Status Score for the intensive care unit (FSS-ICU) into Brazilian Portuguese.
Methods:
This study consisted of the following steps: translation (performed by two independent translators), synthesis of the initial translation, back-translation (by two independent translators who were unaware of the original FSS-ICU), and testing to evaluate the target audience’s understanding. An Expert Committee supervised all steps and was responsible for the modifications made throughout the process and the final translated version.
Results:
The testing phase included two experienced physiotherapists who assessed a total of 30 critical care patients (mean FSS-ICU score = 25 ± 6). As the physiotherapists did not report any uncertainties or problems with interpretation affecting their performance, no additional adjustments were made to the Brazilian Portuguese version after the testing phase. Good interobserver reliability between the two assessors was obtained for each of the 5 FSS-ICU tasks and for the total FSS-ICU score (intraclass correlation coefficients ranged from 0.88 to 0.91).
Conclusion:
The adapted version of the FSS-ICU in Brazilian Portuguese was easy to understand and apply in an intensive care unit environment.
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The use of hyperinflation as a physical therapy resource in intensive care unit
Rev Bras Ter Intensiva. 2007;19(2):221-225
Abstract
The use of hyperinflation as a physical therapy resource in intensive care unit
Rev Bras Ter Intensiva. 2007;19(2):221-225
DOI 10.1590/S0103-507X2007000200014
Views0See moreBACKGROUND AND OBJECTIVES: Mechanically ventilated patients usually present larger amounts of pulmonary secretions because of impairment in mucociliary function and mucus transport. The manual resuscitator is considered a resource for pulmonary hyperinflation with the aim of preventing mucus retention and pulmonary complications, improving oxygenation and reexpanding collapsed areas. Alternatively, the hyperinflation by mechanical ventilator is a reliable and practical device to promote lung expansion and desobstruction. The objective of this study was to review the literature concerning manual and ventilator hyperinflation treatments for patients in the intensive care units (ICU) setting. CONTENTS: Literature searches were performed using the databases MedLine, CINAHL, SciElo and LILACS with appropriate keywords, including: intensive care units, manual hyperinflation, mechanical ventilator, physiotherapy, physical therapy and ventilator hyperinflation. CONCLUSIONS: Although there are few studies demonstrating the efficacy of ventilator hyperinflation as a physical therapy device, it can be a safety option to promote therapeutic hyperinflation in ICU, compared to manual hyperinflation.
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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