You searched for:"Jorge Ibrain Figueira Salluh"
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Research Letter
Generalizing the application of machine learning predictive models across different populations: does a model to predict the use of renal replacement therapy in critically ill COVID-19 patients apply to general intensive care unit patients?
Crit Care Sci. 2024;36:e20240285en
Abstract
Research LetterGeneralizing the application of machine learning predictive models across different populations: does a model to predict the use of renal replacement therapy in critically ill COVID-19 patients apply to general intensive care unit patients?
Crit Care Sci. 2024;36:e20240285en
DOI 10.62675/2965-2774.20240285-pt
Views28TO THE EDITOR The widespread use of machine learning has created the possibility of generating robust prediction models for individual patients; however, caution is needed in their use for heterogeneous critically ill populations.() Recent literature has demonstrated major advances in the field of acute kidney injury prediction and the need for renal replacement therapy (RRT).() […]See more -
Editorial
Open-access publications: a double-edged sword for critical care researchers in lowand middle-income countries
Crit Care Sci. 2023;35(4):342-344
Abstract
EditorialOpen-access publications: a double-edged sword for critical care researchers in lowand middle-income countries
Crit Care Sci. 2023;35(4):342-344
DOI 10.5935/2965-2774.20230263-pt
Views39Open access model and lowand middle-income countries Open access journals usually exempt researchers from low-income countries from publication fees, and this exemption seems to favor the publication of articles by researchers from sub-Saharan Africa.() However, producing high-quality scientific research in these settings is challenging and often funded by agencies such as the National Institutes of […]See more -
Review
High-value care for critically ill oncohematological patients: what do we know thus far?
Crit Care Sci. 2023;35(1):84-96
Abstract
ReviewHigh-value care for critically ill oncohematological patients: what do we know thus far?
Crit Care Sci. 2023;35(1):84-96
DOI 10.5935/2965-2774.20230405-pt
Views6ABSTRACT
The number of patients with cancer requiring intensive care unit admission is increasing around the world. The improvement in the pathophysiological understanding of this group of patients, as well as the increasingly better and more targeted treatment options for their underlying disease, has led to a significant increase in their survival over the past three decades. Within the organizational concepts, it is necessary to know what adds value in the care of critical oncohematological patients. Practices in medicine that do not benefit patients and possibly cause harm are called low-value practices, while high-value practices are defined as high-quality care at relatively low cost. In this article, we discuss ten domains with high-value evidence in the care of cancer patients: (1) intensive care unit admission policies; (2) intensive care unit organization; (3) etiological investigation of hypoxemia; (4) management of acute respiratory failure; (5) management of febrile neutropenia; (6) urgent chemotherapy treatment in critically ill patients; (7) patient and family experience; (8) palliative care; (9) care of intensive care unit staff; and (10) long-term impact of critical disease on the cancer population. The disclosure of such policies is expected to have the potential to change health care standards. We understand that it is a lengthy process, and initiatives such as this paper are one of the first steps in raising awareness and beginning a discussion about high-value care in various health scenarios.
Keywords:Cost of illnessCritical illnessHospital costsIntensive care unitsLow-value careNeoplasmsPatient care managementSee more -
Original Article
Perceptions and practices regarding light sedation in mechanically ventilated patients: a survey on the attitudes of Brazilian critical care physicians
Rev Bras Ter Intensiva. 2022;34(4):426-432
Abstract
Original ArticlePerceptions and practices regarding light sedation in mechanically ventilated patients: a survey on the attitudes of Brazilian critical care physicians
Rev Bras Ter Intensiva. 2022;34(4):426-432
DOI 10.5935/0103-507X.20220278-en
Views3ABSTRACT
Objective:
To characterize the knowledge and perceived attitudes toward pharmacologic interventions for light sedation in mechanically ventilated patients and to understand the current gaps comparing current practice with the recommendations of the Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the Intensive Care Unit.
Methods:
This was a cross-sectional cohort study based on the application of an electronic questionnaire focused on sedation practices.
Results:
A total of 303 critical care physicians provided responses to the survey. Most respondents reported routine use of a structured sedation scale (281; 92.6%). Almost half of the respondents reported performing daily interruptions of sedation (147; 48.4%), and the same percentage of participants (48.0%) agreed that patients are often over sedated. During the COVID-19 pandemic, participants reported that patients had a higher chance of receiving midazolam compared to before the pandemic (178; 58.8% versus 106; 34.0%; p = 0.05), and heavy sedation was more common during the COVID-19 pandemic (241; 79.4% versus 148; 49.0%; p = 0.01).
Conclusion:
This survey provides valuable data on the perceived attitudes of Brazilian intensive care physicians regarding sedation. Although daily interruption of sedation was a well-known concept and sedation scales were often used by the respondents, insufficient effort was put into frequent monitoring, use of protocols and systematic implementation of sedation strategies. Despite the perception of the benefits linked with light sedation, there is a need to identify improvement targets to propose educational strategies to improve current practices.
Keywords:artificialattitudesConscious sedationHealth knowledgeIntensive care unitspracticeRespirationSurveys and questionnairesSee more -
Commentary
Leveraging a national cloud-based intensive care registry for COVID-19 surveillance, research and case-mix evaluation in Brazil
Rev Bras Ter Intensiva. 2022;34(2):205-209
Abstract
CommentaryLeveraging a national cloud-based intensive care registry for COVID-19 surveillance, research and case-mix evaluation in Brazil
Rev Bras Ter Intensiva. 2022;34(2):205-209
DOI 10.5935/0103-507X.20220016-en
Views5INTRODUCTIONLarge national databases of intensive care units (ICUs) generate valuable information for the management and guidance of public policies.() These national ICU registries were established in high-income countries more than 20 years ago. Their contribution to the understanding of case mix and outcomes of ICU patients as well as to clinical research and quality improvement […]See more -
Special Article
Statistical analysis of a cluster-randomized clinical trial on adult general intensive care units in Brazil: TELE-critical care verSus usual Care On ICU PErformance (TELESCOPE) trial
Rev Bras Ter Intensiva. 2022;34(1):87-95
Abstract
Special ArticleStatistical analysis of a cluster-randomized clinical trial on adult general intensive care units in Brazil: TELE-critical care verSus usual Care On ICU PErformance (TELESCOPE) trial
Rev Bras Ter Intensiva. 2022;34(1):87-95
DOI 10.5935/0103-507x.20220003-en
Views2ABSTRACT
Objective:
The TELE-critical Care verSus usual Care On ICU PErformance (TELESCOPE) trial aims to assess whether a complex telemedicine intervention in intensive care units, which focuses on daily multidisciplinary rounds performed by remote intensivists, will reduce intensive care unit length of stay compared to usual care.
Methods:
The TELESCOPE trial is a national, multicenter, controlled, open label, cluster randomized trial. The study tests the effectiveness of daily multidisciplinary rounds conducted by an intensivist through telemedicine in Brazilian intensive care units. The protocol was approved by the local Research Ethics Committee of the coordinating study center and by the local Research Ethics Committee from each of the 30 intensive care units, following Brazilian legislation. The trial is registered with ClinicalTrials. gov (NCT03920501). The primary outcome is intensive care unit length of stay, which will be analyzed accounting for the baseline period and cluster structure of the data and adjusted by prespecified covariates. Secondary exploratory outcomes included intensive care unit performance classification, in-hospital mortality, incidence of nosocomial infections, ventilator-free days at 28 days, rate of patients receiving oral or enteral feeding, rate of patients under light sedation or alert and calm, and rate of patients under normoxemia.
Conclusion:
According to the trial’s best practice, we report our statistical analysis prior to locking the database and beginning analyses. We anticipate that this reporting practice will prevent analysis bias and improve the interpretation of the reported results.
Keywords:BrazilCritical careData interpretation, statisticalHospital mortalityIntensive care unitsLength of stayPatient care teamResearch designTelemedicineSee more -
Commentary
What every intensivist should know about light sedation for mechanically ventilated patients
Rev Bras Ter Intensiva. 2021;33(4):480-482
Abstract
CommentaryWhat every intensivist should know about light sedation for mechanically ventilated patients
Rev Bras Ter Intensiva. 2021;33(4):480-482
DOI 10.5935/0103-507X.20210069
Views3INTRODUCTIONPain, agitation and anxiety are frequently experienced by patients requiring intensive care unit (ICU) admission. These events are often associated with tracheal intubation, mechanical ventilation (MV) and bedside procedures. Sedatives and analgesics can be used to minimize distress, ensure comfort, and decrease the work of breathing to achieve better synchrony with the ventilator. A number […]See more
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness ICU 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