You searched for:"Rui Moreno"
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Viewpoint
Why the Sequential Organ Failure Assessment score needs updating?
Crit Care Sci. 2024;36:e20240296en
Abstract
ViewpointWhy the Sequential Organ Failure Assessment score needs updating?
Crit Care Sci. 2024;36:e20240296en
DOI 10.62675/2965-2774.20240296-pt
Views179The Sequential Organ Failure Assessment (SOFA) score was developed almost 30 years ago. It rapidly became one of the most widely used scoring systems in intensive care, both for clinical practice and research,(,) and remains one of the most cited scores in our speciality. Since its original description, there have been substantial changes in clinical […]See more -
Case Report
Reversible contrast-induced encephalopathy after coil embolization of epistaxis
Rev Bras Ter Intensiva. 2021;33(2):331-335
Abstract
Case ReportReversible contrast-induced encephalopathy after coil embolization of epistaxis
Rev Bras Ter Intensiva. 2021;33(2):331-335
DOI 10.5935/0103-507X.20210043
Views0ABSTRACT
A 37-year-old woman (35 weeks pregnant) was admitted to a local hospital due to severe epistaxis resulting in shock and the need for emergency cesarean section. After failure to tamponade the bleeding, angiographic treatment was provided. After the procedure, she was admitted to the neurocritical intensive care unit and was confused and agitated, requiring sedation and endotracheal intubation. In the intensive care unit, diagnostic investigations included brain magnetic resonance imaging, lumbar puncture with viral panel, electroencephalogram, tests for autoimmunity, and hydroelectrolytic and metabolic evaluations. Magnetic resonance imaging showed a puntiform restricted diffusion area on the left corona radiata on diffusion weighted imaging and mild cortical posterior edema (without restricted diffusion), and an electroencephalogram showed moderate diffuse slow activity and fronto-temporal slow activity of the left hemisphere with associated scarce paroxysmal components. The other exams did not show any relevant alterations. Due to the temporal relationship, the clinical history and the magnetic resonance imaging results, a diagnosis of contrast-induced encephalopathy was made. After 2 days in the intensive care unit, sedation was withdrawn, the patient was extubated, and total neurological recovery was verified within the next 24 hours.
Keywords:Brain diseases/chemically inducedContrast media/adverse effectsEpistaxisPregnancy complicationsSee more -
Editorial
Five hundred twelve years of history together… and many more years to come
Rev Bras Ter Intensiva. 2012;24(2):111-112
Abstract
EditorialFive hundred twelve years of history together… and many more years to come
Rev Bras Ter Intensiva. 2012;24(2):111-112
DOI 10.1590/S0103-507X2012000200001
Views2EDITORIAL Five hundred twelve years of history together… and many more years to come […]See more -
Original Articles – Clinical Research
Prevalence and outcomes of infections in Brazilian ICUs: a subanalysis of EPIC II study
Rev Bras Ter Intensiva. 2012;24(2):143-150
Abstract
Original Articles – Clinical ResearchPrevalence and outcomes of infections in Brazilian ICUs: a subanalysis of EPIC II study
Rev Bras Ter Intensiva. 2012;24(2):143-150
DOI 10.1590/S0103-507X2012000200008
Views0See moreOBJECTIVE: To determine the prevalence of infections in Brazilian intensive care units and the associated mortality by analyzing the data obtained in the Extended Prevalence of Infection in Intensive Care (EPIC II) study. METHODS: EPIC II was a multicenter, international, cross-sectional prospective study of infection prevalence. It described the demographic, physiological, bacteriological, and therapeutic characteristics, outcome up to the 60th day, prevalence of infection, and mortality of all the patients admitted to the participating ICUs between zero hour and midnight on May 8, 2007. A total of 14,414 patients were included in the original study. Of these 14,414 patients, 1,235 were Brazilian and were hospitalized in 90 Brazilian ICUs. They represent the focus of this study. RESULTS: Among these 1,235 Brazilian patients, 61,6% had an infection on the day of the trial, and the lungs were the main site of infection (71.2%). Half of the patients had positive cultures, predominantly gram-negative bacilli (72%). On the day of the study, the median SOFA score was 5 (3-8) and the median SAPS II score was 36 (26-47). The infected patients had SOFA scores significantly higher than those of the non-infected patients 6 (4-9) and 3 (2-6), respectively). The overall ICU mortality rate was 28.4%: 37.6% in the infected patients, and 13.2% in the non-infected patients (p<0.001). Similarly, the in-hospital mortality rate was 34.2%, with a higher rate in the infected than in the non-infected patients (44.2% vs. 17.7%) (p<0.001). In the multivariate analysis, the main factors associated with infection incidence were emergency surgery (OR 2.89, 95%CI [1.72-4.86], p<0.001), mechanical ventilation (OR 2.06, 95% CI [1.5-2.82], p<0.001), and the SAPS II score (OR 1.04, 95% CI [1.03-1.06], p<0.001). The main factors related to mortality were ICC functional class III/ IV (OR 3.0, 95% CI [1.51-5.98], p<0.01), diabetes mellitus (OR 0.48, 95% CI [0.25-0.95], p<0.03), cirrhosis (OR 4.62, 95% CI [1.47-14,5], p<0.01), male gender (OR 0.68, 95% CI [0.46-1.0], p<0.05), mechanical ventilation (OR 1.87, 95% CI [1.19-2.95], p<0.01), hemodialysis (OR 1.98, 95% CI [1.05-3.75], p<0.03), and the SAPS II score (OR 1.08, 95% CI [1.06-1.10], p<0.001). CONCLUSION: The present study revealed a higher prevalence of infections in Brazilian ICUs than has been previously reported. There was a clear association between infection and mortality.
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness 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 Septic shock