You searched for:"Valéria Cabral Neves"
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Original Article
Performance and labor conditions of physiotherapists in Brazilian intensive care units during the COVID-19 pandemic. What did we learn?
- Andressa Sabrina de Oliveira Resende
, - Suzi Laine Longo dos Santos Bacci ,
- Ítalo Ribeiro Paula ,
- Leandro Alves Pereira ,
- Cíntia Johnston , [ … ],
- Vívian Mara Gonçalves de Oliveira Azevedo
Abstract
Original ArticlePerformance and labor conditions of physiotherapists in Brazilian intensive care units during the COVID-19 pandemic. What did we learn?
Crit Care Sci. 2023;35(3):273-280
DOI 10.5935/2965-2774.20230359-pt
- Andressa Sabrina de Oliveira Resende ,
- Suzi Laine Longo dos Santos Bacci ,
- Ítalo Ribeiro Paula ,
- Leandro Alves Pereira ,
- Cíntia Johnston ,
- Valéria Cabral Neves Luszczynski ,
- Vívian Mara Gonçalves de Oliveira Azevedo
Views5ABSTRACT
Objective:
To describe the role of physiotherapists in assisting patients suspected to have or diagnosed with COVID-19 hospitalized in intensive care units in Brazil regarding technical training, working time, care practice, labor conditions and remuneration.
Methods:
An analytical cross-sectional survey was carried out through an electronic questionnaire distributed to physiotherapists who worked in the care of patients with COVID-19 in Brazilian intensive care units.
Results:
A total of 657 questionnaires were completed by physiotherapists from the five regions of the country, with 85.3% working in adult, 5.4% in neonatal, 5.3% in pediatric and 3.8% in mixed intensive care units (pediatric and neonatal). In intensive care units with a physiotherapists available 24 hours/day, physiotherapists worked more frequently (90.6%) in the assembly, titration, and monitoring of noninvasive ventilation (p = 0.001). Most intensive care units with 12-hour/day physiotherapists (25.8%) did not apply any protocol compared to intensive care units with 18-hour/day physiotherapy (9.9%) versus 24 hours/day (10.2%) (p = 0.032). Most of the respondents (51.0%) received remuneration 2 or 3 times the minimum wage, and only 25.1% received an additional payment for working with patients suspected to have or diagnosed with COVID-19; 85.7% of them did not experience a lack of personal protective equipment.
Conclusion:
Intensive care units with 24-hour/day physiotherapists had higher percentages of protocols and noninvasive ventilation for patients with COVID-19. The use of specific resources varied between the types of intensive care units and hospitals and in relation to the physiotherapists’ labor conditions. This study showed that most professionals had little experience in intensive care and low wages.
Keywords:COVID-19Intensive care unitsOccupational risksPhysiotherapistsProfessional trainingRemunerationSurvey and questionnairesWork hoursSee moreViews5
Abstract
Original ArticlePerformance and labor conditions of physiotherapists in Brazilian intensive care units during the COVID-19 pandemic. What did we learn?
Crit Care Sci. 2023;35(3):273-280
DOI 10.5935/2965-2774.20230359-pt
- Andressa Sabrina de Oliveira Resende ,
- Suzi Laine Longo dos Santos Bacci ,
- Ítalo Ribeiro Paula ,
- Leandro Alves Pereira ,
- Cíntia Johnston ,
- Valéria Cabral Neves Luszczynski ,
- Vívian Mara Gonçalves de Oliveira Azevedo
Views5ABSTRACT
Objective:
To describe the role of physiotherapists in assisting patients suspected to have or diagnosed with COVID-19 hospitalized in intensive care units in Brazil regarding technical training, working time, care practice, labor conditions and remuneration.
Methods:
An analytical cross-sectional survey was carried out through an electronic questionnaire distributed to physiotherapists who worked in the care of patients with COVID-19 in Brazilian intensive care units.
Results:
A total of 657 questionnaires were completed by physiotherapists from the five regions of the country, with 85.3% working in adult, 5.4% in neonatal, 5.3% in pediatric and 3.8% in mixed intensive care units (pediatric and neonatal). In intensive care units with a physiotherapists available 24 hours/day, physiotherapists worked more frequently (90.6%) in the assembly, titration, and monitoring of noninvasive ventilation (p = 0.001). Most intensive care units with 12-hour/day physiotherapists (25.8%) did not apply any protocol compared to intensive care units with 18-hour/day physiotherapy (9.9%) versus 24 hours/day (10.2%) (p = 0.032). Most of the respondents (51.0%) received remuneration 2 or 3 times the minimum wage, and only 25.1% received an additional payment for working with patients suspected to have or diagnosed with COVID-19; 85.7% of them did not experience a lack of personal protective equipment.
Conclusion:
Intensive care units with 24-hour/day physiotherapists had higher percentages of protocols and noninvasive ventilation for patients with COVID-19. The use of specific resources varied between the types of intensive care units and hospitals and in relation to the physiotherapists’ labor conditions. This study showed that most professionals had little experience in intensive care and low wages.
Keywords:COVID-19Intensive care unitsOccupational risksPhysiotherapistsProfessional trainingRemunerationSurvey and questionnairesWork hoursSee more - Andressa Sabrina de Oliveira Resende
-
Original Article
Fitness checklist model for spontaneous breathing tests in pediatrics
- Bruno Silva Miranda ,
- Valéria Cabral Neves ,
- Yessa do Prado Albuquerque ,
- Emilly Freitas de Souza ,
- Adriana Koliski , [ … ],
- José Eduardo Carreiro
Abstract
Original ArticleFitness checklist model for spontaneous breathing tests in pediatrics
Crit Care Sci. 2023;35(1):66-72
DOI 10.5935/2965-2774.20230312-pt
- Bruno Silva Miranda ,
- Valéria Cabral Neves ,
- Yessa do Prado Albuquerque ,
- Emilly Freitas de Souza ,
- Adriana Koliski ,
- Mônica Nunes Lima Cat ,
- José Eduardo Carreiro
Views4ABSTRACT
Objective:
To evaluate whether a model of a daily fitness checklist for spontaneous breathing tests is able to identify predictive variables of extubation failure in pediatric patients admitted to a Brazilian intensive care unit.
Methods:
This was a single-center, cross-sectional study with prospective data collection. The checklist model comprised 20 items and was applied to assess the ability to perform spontaneous breathing tests.
Results:
The sample consisted of 126 pediatric patients (85 males (67.5%)) on invasive mechanical ventilation, for whom 1,217 daily assessments were applied at the bedside. The weighted total score of the prediction model showed the highest discriminatory power for the spontaneous breathing test, with sensitivity and specificity indices for fitness failure of 89.7% or success of 84.6%. The cutoff point suggested by the checklist was 8, with a probability of extubation failure less than 5%. Failure increased progressively with increasing score, with a maximum probability of predicting extubation failure of 85%.
Conclusion:
The extubation failure rate with the use of this model was within what is acceptable in the literature. The daily checklist model for the spontaneous breathing test was able to identify predictive variables of failure in the extubation process in pediatric patients.
Keywords:Airway extubationChecklistChildIntensive care units, pediatricRespiration, artificialRespiratory function testSee moreViews4Abstract
Original ArticleFitness checklist model for spontaneous breathing tests in pediatrics
Crit Care Sci. 2023;35(1):66-72
DOI 10.5935/2965-2774.20230312-pt
- Bruno Silva Miranda ,
- Valéria Cabral Neves ,
- Yessa do Prado Albuquerque ,
- Emilly Freitas de Souza ,
- Adriana Koliski ,
- Mônica Nunes Lima Cat ,
- José Eduardo Carreiro
Views4ABSTRACT
Objective:
To evaluate whether a model of a daily fitness checklist for spontaneous breathing tests is able to identify predictive variables of extubation failure in pediatric patients admitted to a Brazilian intensive care unit.
Methods:
This was a single-center, cross-sectional study with prospective data collection. The checklist model comprised 20 items and was applied to assess the ability to perform spontaneous breathing tests.
Results:
The sample consisted of 126 pediatric patients (85 males (67.5%)) on invasive mechanical ventilation, for whom 1,217 daily assessments were applied at the bedside. The weighted total score of the prediction model showed the highest discriminatory power for the spontaneous breathing test, with sensitivity and specificity indices for fitness failure of 89.7% or success of 84.6%. The cutoff point suggested by the checklist was 8, with a probability of extubation failure less than 5%. Failure increased progressively with increasing score, with a maximum probability of predicting extubation failure of 85%.
Conclusion:
The extubation failure rate with the use of this model was within what is acceptable in the literature. The daily checklist model for the spontaneous breathing test was able to identify predictive variables of failure in the extubation process in pediatric patients.
Keywords:Airway extubationChecklistChildIntensive care units, pediatricRespiration, artificialRespiratory function testSee more
- Bruno Silva Miranda
-
Original Articles
Atelectasis and lung changes in preterm neonates in the neonatal period: a blind radiological report and clinical findings
- Anne Karoline Santos ,
- Jaqueline Silveira,
- Valéria Cabral Neves,
- Talita Gianello Gnoato Zotz,
- Arlete Ana Motter, [ … ],
- Marimar Goretti Andreazza
Abstract
Original ArticlesAtelectasis and lung changes in preterm neonates in the neonatal period: a blind radiological report and clinical findings
Rev Bras Ter Intensiva. 2019;31(3):347-353
DOI 10.5935/0103-507X.20190047
- Anne Karoline Santos ,
- Jaqueline Silveira,
- Valéria Cabral Neves,
- Talita Gianello Gnoato Zotz,
- Arlete Ana Motter,
- Marimar Goretti Andreazza
Views0ABSTRACT
Objective:
To determine the occurrence and characteristics of atelectasis, opacities, hypolucency and pulmonary infiltrates observed on chest X-rays of preterm infants in a neonatal intensive care unit.
Methods:
This was a cross-sectional observational study. From August to December 2017, all chest radiographs of newborn infants were analyzed. The study included the chest radiographs of preterm neonates with gestational ages up to 36 weeks in the neonatal period that showed clear changes or suspected changes, which were confirmed after a radiologist’s report. Radiological changes were associated with possible predisposing factors.
Results:
During the study period, 450 radiographs were performed on preterm neonates, and 37 lung changes were identified and classified into 4 types: 12 (2.66%) changes were described as opacities, 11 (2.44%) were described as atelectasis, 10 (2.22%) were described as pulmonary infiltrate, and 4 (0.88%) were described as hypolucency. A higher occurrence of atelectasis was noted in the right lung (81.8%). Among the abnormal radiographs, 25 (67.6%) newborn infants were receiving invasive mechanical ventilation.
Conclusion:
Considering the radiological report, no significance was found for the observed changes. Atelectasis was not the most frequently observed change. The predisposing factors for these changes were extreme prematurity, low weight, male sex, a poorly positioned endotracheal tube and the use of invasive mechanical ventilation.
Keywords:Diagnostic imagingInfant, prematureIntensive care units, neonatalPremature birthPulmonary atelectasisThorax/diagnostic imagingSee moreViews0Abstract
Original ArticlesAtelectasis and lung changes in preterm neonates in the neonatal period: a blind radiological report and clinical findings
Rev Bras Ter Intensiva. 2019;31(3):347-353
DOI 10.5935/0103-507X.20190047
- Anne Karoline Santos ,
- Jaqueline Silveira,
- Valéria Cabral Neves,
- Talita Gianello Gnoato Zotz,
- Arlete Ana Motter,
- Marimar Goretti Andreazza
Views0ABSTRACT
Objective:
To determine the occurrence and characteristics of atelectasis, opacities, hypolucency and pulmonary infiltrates observed on chest X-rays of preterm infants in a neonatal intensive care unit.
Methods:
This was a cross-sectional observational study. From August to December 2017, all chest radiographs of newborn infants were analyzed. The study included the chest radiographs of preterm neonates with gestational ages up to 36 weeks in the neonatal period that showed clear changes or suspected changes, which were confirmed after a radiologist’s report. Radiological changes were associated with possible predisposing factors.
Results:
During the study period, 450 radiographs were performed on preterm neonates, and 37 lung changes were identified and classified into 4 types: 12 (2.66%) changes were described as opacities, 11 (2.44%) were described as atelectasis, 10 (2.22%) were described as pulmonary infiltrate, and 4 (0.88%) were described as hypolucency. A higher occurrence of atelectasis was noted in the right lung (81.8%). Among the abnormal radiographs, 25 (67.6%) newborn infants were receiving invasive mechanical ventilation.
Conclusion:
Considering the radiological report, no significance was found for the observed changes. Atelectasis was not the most frequently observed change. The predisposing factors for these changes were extreme prematurity, low weight, male sex, a poorly positioned endotracheal tube and the use of invasive mechanical ventilation.
Keywords:Diagnostic imagingInfant, prematureIntensive care units, neonatalPremature birthPulmonary atelectasisThorax/diagnostic imagingSee more
- Anne Karoline Santos
-
Review Articles
Alveolar recruitment maneuver in mechanic ventilation pediatric intensive care unit children
Rev Bras Ter Intensiva. 2009;21(4):453-460
Abstract
Review ArticlesAlveolar recruitment maneuver in mechanic ventilation pediatric intensive care unit children
Rev Bras Ter Intensiva. 2009;21(4):453-460
DOI 10.1590/S0103-507X2009000400017
Views0See moreRecent changes were introduced in acute hypoxemic respiratory failure children ventilation methods. There are evidences that less aggressive ventilation strategies can improve severe pulmonary injury survival. Experimental trials evidenced a relationship between inappropriate ventilatory measures and delayed acute pulmonary injury improvement, or even worsening. From this, a protective ventilatory measure arises in combination with alveolar recruitment maneuver. This association is believed in clinical practice to determine importantly reduced morbidity and mortality as well as reduced mechanic ventilation-induced injuries. It is indicated for acute lung injury patients, generally from pneumonia or sepsis, with severe hypoxemia. Its main contraindications are homodynamic instability, pneumothorax and intracranial hypertension. Experimental trials showed beneficial maneuver effects on both oxygenation and alveolar collapse. Adult studies showed improved pulmonary function with hypoxemia reversion. In children, the maneuver lead to significant inspired oxygen fraction and alveolar collapse reductions, less oxygen dependency, improved pulmonary complacency, and reduced bronchopulmonary dysplasia. However, studies in children are limited. Additional investigation is warranted on this matter, and its clinical application evidence. A literature review was conducted based on textbooks and MEDLINE, Pubmed, Cochrane library, SciELO, and Ovid databases, from 1998 to 2009, both in Portuguese and English. Publications on alveolar recruitment maneuver both in adults and children, review articles, experimental and clinical trials were included using the key words: protective ventilatory strategy, alveolar recruitment maneuver, pediatrics and mechanic ventilation.
Views0Abstract
Review ArticlesAlveolar recruitment maneuver in mechanic ventilation pediatric intensive care unit children
Rev Bras Ter Intensiva. 2009;21(4):453-460
DOI 10.1590/S0103-507X2009000400017
Views0See moreRecent changes were introduced in acute hypoxemic respiratory failure children ventilation methods. There are evidences that less aggressive ventilation strategies can improve severe pulmonary injury survival. Experimental trials evidenced a relationship between inappropriate ventilatory measures and delayed acute pulmonary injury improvement, or even worsening. From this, a protective ventilatory measure arises in combination with alveolar recruitment maneuver. This association is believed in clinical practice to determine importantly reduced morbidity and mortality as well as reduced mechanic ventilation-induced injuries. It is indicated for acute lung injury patients, generally from pneumonia or sepsis, with severe hypoxemia. Its main contraindications are homodynamic instability, pneumothorax and intracranial hypertension. Experimental trials showed beneficial maneuver effects on both oxygenation and alveolar collapse. Adult studies showed improved pulmonary function with hypoxemia reversion. In children, the maneuver lead to significant inspired oxygen fraction and alveolar collapse reductions, less oxygen dependency, improved pulmonary complacency, and reduced bronchopulmonary dysplasia. However, studies in children are limited. Additional investigation is warranted on this matter, and its clinical application evidence. A literature review was conducted based on textbooks and MEDLINE, Pubmed, Cochrane library, SciELO, and Ovid databases, from 1998 to 2009, both in Portuguese and English. Publications on alveolar recruitment maneuver both in adults and children, review articles, experimental and clinical trials were included using the key words: protective ventilatory strategy, alveolar recruitment maneuver, pediatrics and mechanic ventilation.
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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