You searched for:"Márcio Soares"
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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 -
Original Article
Resuscitation fluid practices in Brazilian intensive care units: a secondary analysis of Fluid-TRIPS
Rev Bras Ter Intensiva. 2021;33(2):206-218
Abstract
Original ArticleResuscitation fluid practices in Brazilian intensive care units: a secondary analysis of Fluid-TRIPS
Rev Bras Ter Intensiva. 2021;33(2):206-218
DOI 10.5935/0103-507X.20210028
Views1See moreAbstract
Objective:
To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS.
Methods:
This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice.
Results:
On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only.
Conclusion:
Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
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Commentary
How to evaluate intensive care unit performance during the COVID-19 pandemic
Rev Bras Ter Intensiva. 2020;32(2):203-206
Abstract
CommentaryHow to evaluate intensive care unit performance during the COVID-19 pandemic
Rev Bras Ter Intensiva. 2020;32(2):203-206
DOI 10.5935/0103-507X.20200040
Views0CONCLUSIONMeasuring the ICU performance was never so important neither so difficult as during the COVID-19 pandemic. While few data on prognostic scores is available, therefore limiting the use of more traditional metrics, ICUs should focus on measuring indirect performance parameters, especially analyzing case-mix, outcomes, and the rate of adherence to best practices.[…]See more -
Letter to the Editor
Reply to: The Epimed Monitor ICU Database®: a cloud-based national registry for adult intensive care unit patients in Brazil
Rev Bras Ter Intensiva. 2018;30(3):398-398
Abstract
Letter to the EditorReply to: The Epimed Monitor ICU Database®: a cloud-based national registry for adult intensive care unit patients in Brazil
Rev Bras Ter Intensiva. 2018;30(3):398-398
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Original Articles
The Epimed Monitor ICU Database®: a cloud-based national registry for adult intensive care unit patients in Brazil
Rev Bras Ter Intensiva. 2017;29(4):418-426
Abstract
Original ArticlesThe Epimed Monitor ICU Database®: a cloud-based national registry for adult intensive care unit patients in Brazil
Rev Bras Ter Intensiva. 2017;29(4):418-426
DOI 10.5935/0103-507X.20170062
Views7See moreABSTRACT
Objective:
To describe the Epimed Monitor Database®, a Brazilian intensive care unit quality improvement database.
Methods:
We described the Epimed Monitor® Database, including its structure and core data. We presented aggregated informative data from intensive care unit admissions from 2010 to 2016 using descriptive statistics. We also described the expansion and growth of the database along with the geographical distribution of participating units in Brazil.
Results:
The core data from the database includes demographic, administrative and physiological parameters, as well as specific report forms used to gather detailed data regarding the use of intensive care unit resources, infectious episodes, adverse events and checklists for adherence to best clinical practices. As of the end of 2016, 598 adult intensive care units in 318 hospitals totaling 8,160 intensive care unit beds were participating in the database. Most units were located at private hospitals in the southeastern region of the country. The number of yearly admissions rose during this period and included a predominance of medical admissions. The proportion of admissions due to cardiovascular disease declined, while admissions due to sepsis or infections became more common. Illness severity (Simplified Acute Physiology Score – SAPS 3 – 62 points), patient age (mean = 62 years) and hospital mortality (approximately 17%) remained reasonably stable during this time period.
Conclusion:
A large private database of critically ill patients is feasible and may provide relevant nationwide epidemiological data for quality improvement and benchmarking purposes among the participating intensive care units. This database is useful not only for administrative reasons but also for the improvement of daily care by facilitating the adoption of best practices and use for clinical research.
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Commentaries
Why should we not use APACHE II for performance measurement and benchmarking?
Rev Bras Ter Intensiva. 2017;29(3):268-270
Abstract
CommentariesWhy should we not use APACHE II for performance measurement and benchmarking?
Rev Bras Ter Intensiva. 2017;29(3):268-270
DOI 10.5935/0103-507X.20170043
Views0The Acute Physiology and Chronic Health Evaluation (APACHE) is the most frequently used general severity-of-illness score in adult intensive care units (ICUs). APACHE scores use clinical, physiological and laboratory data observed at admission and during the first 24 hours after ICU admission. This is in order to estimate a given patient’s severity of illness by […]See more -
Commentaries
What every intensivist should know about prognostic scoring systems and risk-adjusted mortality
Rev Bras Ter Intensiva. 2016;28(3):264-269
Abstract
CommentariesWhat every intensivist should know about prognostic scoring systems and risk-adjusted mortality
Rev Bras Ter Intensiva. 2016;28(3):264-269
DOI 10.5935/0103-507X.20160052
Views0Sequential Organ Failure Assessment: an organ dysfunction scoreMultiple organ dysfunction syndrome is a major cause of ICU morbidity and mortality. The extent and severity of organ dysfunction may be quantified in a number of organ dysfunction scores, the most prominent of which is the SOFA.() Originally designed to be used in patients with sepsis, the […]See more -
Review Articles
Use of biomarkers in pediatric sepsis: literature review
Rev Bras Ter Intensiva. 2016;28(4):472-482
Abstract
Review ArticlesUse of biomarkers in pediatric sepsis: literature review
Rev Bras Ter Intensiva. 2016;28(4):472-482
DOI 10.5935/0103-507X.20160080
Views0See moreABSTRACT
Despite advances in recent years, sepsis is still a leading cause of hospitalization and mortality in infants and children. The presence of biomarkers during the response to an infectious insult makes it possible to use such biomarkers in screening, diagnosis, prognosis (risk stratification), monitoring of therapeutic response, and rational use of antibiotics (for example, the determination of adequate treatment length). Studies of biomarkers in sepsis in children are still relatively scarce. This review addresses the use of biomarkers in sepsis in pediatric patients with emphasis on C-reactive protein, procalcitonin, interleukins 6, 8, and 18, human neutrophil gelatinase, and proadrenomedullin. Assessment of these biomarkers may be useful in the management of pediatric sepsis.
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KEY WORDS
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