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You searched for:"Luiz Alberto Forgiarini Jr."

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  • Original Articles

    Clinical attitudes and perceived barriers to early mobilization of critically ill patients in adult intensive care units

    Rev Bras Ter Intensiva. 2018;30(2):187-194

    Abstract

    Original Articles

    Clinical attitudes and perceived barriers to early mobilization of critically ill patients in adult intensive care units

    Rev Bras Ter Intensiva. 2018;30(2):187-194

    DOI 10.5935/0103-507X.20180037

    Views1

    ABSTRACT

    Objective:

    To investigate the knowledge of multi-professional staff members about the early mobilization of critically ill adult patients and identify attitudes and perceived barriers to its application.

    Methods:

    A cross-sectional study was conducted during the second semester of 2016 with physicians, nursing professionals and physical therapists from six intensive care units at two teaching hospitals. Questions were answered on a 5-point Likert scale and analyzed as proportions of professionals who agreed or disagreed with statements. The chi-square and Fisher's exact tests were used to investigate differences in the responses according to educational/training level, previous experience with early mobilization and years of experience in intensive care units.

    Results:

    The questionnaire was answered by 98 out of 514 professionals (response rate: 19%). The acknowledged benefits of early mobilization were maintenance of muscle strength (53%) and shortened length of mechanical ventilation (83%). Favorable attitudes toward early mobilization included recognition that its benefits for patients under mechanical ventilation exceed the risks for both patients and staff, that early mobilization should be routinely performed via nursing and physical therapy protocols, and readiness to change the parameters of mechanical ventilation and reduce sedation to facilitate the early mobilization of patients. The main barriers mentioned were the unavailability of professionals and time to mobilize patients, excessive sedation, delirium, risk of musculoskeletal self-injury and excessive stress at work.

    Conclusion:

    The participants were aware of the benefits of early mobilization and manifested attitudes favorable to its application. However, the actual performance of early mobilization was perceived as a challenge, mainly due to the lack of professionals and time, excessive sedation, delirium, risk of musculoskeletal self-injury and excessive stress at work.

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    Clinical attitudes and perceived barriers to early mobilization of critically ill patients in adult intensive care units
  • Review Article

    Quality of life in survivors after a period of hospitalization in the intensive care unit: a systematic review

    Rev Bras Ter Intensiva. 2018;30(4):496-507

    Abstract

    Review Article

    Quality of life in survivors after a period of hospitalization in the intensive care unit: a systematic review

    Rev Bras Ter Intensiva. 2018;30(4):496-507

    DOI 10.5935/0103-507X.20180071

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    ABSTRACT

    Objective:

    To assess the long-term, health-related quality of life of intensive care unit survivors by systematic review.

    Methods:

    The search for, and selection and analysis of, observational studies that assessed the health-related quality of life of intensive care unit survivors in the electronic databases LILACS and MEDLINE® (accessed through PubMed) was performed using the indexed MESH terms "quality of life [MeSH Terms]" AND "critically illness [MeSH Terms]". Studies on adult patients without specific prior diseases published in English in the last 5 years were included in this systematic review. The citations were independently selected by three reviewers. Data were standardly and independently retrieved by two reviewers, and the quality of the studies was assessed using the Newcastle-Ottawa scale.

    Results:

    In total, 19 observational cohort and 2 case-control studies of 57,712 critically ill patients were included. The follow-up time of the studies ranged from 6 months to 6 years, and most studies had a 6-month or 1-year follow up. The health-related quality of life was assessed using two generic tools, the EuroQol and the Short Form Health Survey. The overall quality of the studies was low.

    Conclusions:

    Long-term, health-related quality of life is compromised among intensive care unit survivors compared with the corresponding general population. However, it is not significantly affected by the occurrence of sepsis, delirium, and acute kidney injury during intensive care unit admission when compared with that of critically ill patient control groups. High-quality studies are necessary to quantify the health-related quality of life among intensive care unit survivors.

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    Quality of life in survivors after a period of hospitalization in the intensive care unit: a systematic review
  • Artigos de Revisão

    Variable mechanical ventilation

    Rev Bras Ter Intensiva. 2017;29(1):77-86

    Abstract

    Artigos de Revisão

    Variable mechanical ventilation

    Rev Bras Ter Intensiva. 2017;29(1):77-86

    DOI 10.5935/0103-507X.20170012

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    ABSTRACT

    Objective:

    To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique.

    Methods:

    Search, selection, and analysis of all original articles on variable ventilation, without restriction on the period of publication and language, available in the electronic databases LILACS, MEDLINE®, and PubMed, by searching the terms "variable ventilation" OR "noisy ventilation" OR "biologically variable ventilation".

    Results:

    A total of 36 studies were selected. Of these, 24 were original studies, including 21 experimental studies and three clinical studies.

    Conclusion:

    Several experimental studies reported the beneficial effects of distinct variable ventilation strategies on lung function using different models of lung injury and healthy lungs. Variable ventilation seems to be a viable strategy for improving gas exchange and respiratory mechanics and preventing lung injury associated with mechanical ventilation. However, further clinical studies are necessary to assess the potential of variable ventilation strategies for the clinical improvement of patients undergoing mechanical ventilation.

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    Variable mechanical ventilation

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