You searched for:"Rogério da Hora Passos"
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Original Articles
Factors potentially associated with the decision of admission to the intensive care unit in a middle-income country: a survey of Brazilian physicians
Rev Bras Ter Intensiva. 2017;29(2):154-162
Abstract
Original ArticlesFactors potentially associated with the decision of admission to the intensive care unit in a middle-income country: a survey of Brazilian physicians
Rev Bras Ter Intensiva. 2017;29(2):154-162
DOI 10.5935/0103-507X.20170025
Views0See moreABSTRACT
Objective:
To evaluate the factors potentially associated with the decision of admission to the intensive care unit in Brazil.
Methods:
An electronic survey of Brazilian physicians working in intensive care units. Fourteen variables that were potentially associated with the decision of admission to the intensive care unit were rated as important (from 1 to 5) by the respondents and were later grouped as “patient-related,” “scarcity-related” and “administrative-related” factors. The workplace and physician characteristics were evaluated for correlation with the factor ratings.
Results:
During the study period, 125 physicians completed the survey. The scores on patient-related factors were rated higher on their potential to affect decisions than scarcity-related or administrative-related factors, with a mean ± SD of 3.42 ± 0.7, 2.75 ± 0.7 and 2.87 ± 0.7, respectively (p < 0.001). The patient's underlying illness prognosis was rated by 64.5% of the physicians as always or frequently affecting decisions, followed by acute illness prognosis (57%), number of intensive care unit beds available (56%) and patient's wishes (53%). After controlling for confounders, receiving specific training on intensive care unit triage was associated with higher ratings of the patient-related factors and scarcity-related factors, while working in a public intensive care unit (as opposed to a private intensive care unit) was associated with higher ratings of the scarcity-related factors.
Conclusions:
Patient-related factors were more frequently rated as potentially affecting intensive care unit admission decisions than scarcity-related or administrative-related factors. Physician and workplace characteristics were associated with different factor ratings.
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Case Reports
Heart conduction system defects and sustained ventricular tachycardia complications in a patient with granulomatosis with polyangiitis. A case report and literature review
Rev Bras Ter Intensiva. 2017;29(3):386-390
Abstract
Case ReportsHeart conduction system defects and sustained ventricular tachycardia complications in a patient with granulomatosis with polyangiitis. A case report and literature review
Rev Bras Ter Intensiva. 2017;29(3):386-390
DOI 10.5935/0103-507X.20170052
Views0ABSTRACT
Granulomatosis with polyangiitis is a rare systemic inflammatory disorder characterized by vasculitis of the small arteries, the arterioles and the capillaries together with necrotizing granulomatous lesions. This case reports on a young female patient, previously diagnosed with granulomatosis with polyangiitis, who was admitted to the intensive care unit with seizures and hemodynamic instability due to a complete atrioventricular heart block. The event was associated with multiple episodes of sustained ventricular tachycardia without any structural heart changes or electrolyte disturbances. In the intensive care unit, the patient was fitted with a provisory pacemaker, followed by immunosuppression with corticosteroids and immunobiological therapy, resulting in a total hemodynamic improvement. Severe conduction disorders in patients presenting granulomatosis with polyangiitis are rare but can contribute to increased morbidity. Early detection and specific intervention can prevent unfavorable outcomes, specifically in the intensive care unit.
Keywords:Atrioventricular blockBradycardiaCase reportsGranulomatosis with polyangiitisHeart conduction systemPacemaker, artificialSee more -
Editorial
The new frontiers of acute kidney injury
Rev Bras Ter Intensiva. 2012;24(3):213-215
Abstract
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The role of serial measurement of troponin in patients with a suspected myocardial injury after chest trauma
Rev Bras Ter Intensiva. 2007;19(2):216-220
Abstract
The role of serial measurement of troponin in patients with a suspected myocardial injury after chest trauma
Rev Bras Ter Intensiva. 2007;19(2):216-220
DOI 10.1590/S0103-507X2007000200013
Views0See moreBACKGROUND AND OBJECTIVES: Myocardial contusion is often associated with blunt chest trauma. Its diagnosis is challenging to the professionals who work in emergency department due to nonspecific symptoms and the lack of auxiliary exams with enough accuracy to diagnose. Among the available diagnostic tools, the biomarkers of myocardial injury troponin I and troponin T have stood out. Troponins are proteins of the citocellular apparatus, released into the bloodstream only after the disruption of myocytes cellular membrane. Therefore they are highly specific to detect myocardial injuries. CONTENTS: We performed a clinical review using the electronic databases MedLine and LILACS from January 1980 to November 2006 about the importance of a serial measurement of troponin I and T as a diagnostic tool as well as predictor of unfavorable clinical outcome in patients with myocardial contusion after a blunt chest trauma. CONCLUSIONS: Although troponins I and T are more specific than usual biomarkers CKMB and CK, these two first biomarkers show a low sensitivity and positive predictive value to diagnosis myocardial contusion. Patients with ECG abnormalities, troponins elevations or both should remain in an intensive care unit (ICU) for at least 24 hours, period in which they cam develop most of the complications related to myocardial contusion.
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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