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Rev Bras Ter Intensiva. 2021;33(2):261-265
DOI 10.5935/0103-507X.20210033
To identify the possible association between driving pressure and mechanical power values and oxygenation index on the first day of mechanical ventilation with the mortality of trauma patients without a diagnosis of acute respiratory distress syndrome.
Patients under pressure-controlled or volume-controlled ventilation were included, with data collection 24 hours after orotracheal intubation. Patient follow-up was performed for 30 days to obtain the clinical outcome. The patients were admitted to two intensive care units of the Hospital de Pronto Socorro de Porto Alegre from June to September 2019.
A total of 24 patients were evaluated. Driving pressure, mechanical power and oxygenation index were similar among patients who survived and those who died, with no statistically significant difference between groups.
Driving pressure, mechanical power and oxygenation index values obtained on the first day of mechanical ventilation were not associated with mortality of trauma patients without acute respiratory distress syndrome.
Abstract
Rev Bras Ter Intensiva. 2021;33(2):261-265
DOI 10.5935/0103-507X.20210033
To identify the possible association between driving pressure and mechanical power values and oxygenation index on the first day of mechanical ventilation with the mortality of trauma patients without a diagnosis of acute respiratory distress syndrome.
Patients under pressure-controlled or volume-controlled ventilation were included, with data collection 24 hours after orotracheal intubation. Patient follow-up was performed for 30 days to obtain the clinical outcome. The patients were admitted to two intensive care units of the Hospital de Pronto Socorro de Porto Alegre from June to September 2019.
A total of 24 patients were evaluated. Driving pressure, mechanical power and oxygenation index were similar among patients who survived and those who died, with no statistically significant difference between groups.
Driving pressure, mechanical power and oxygenation index values obtained on the first day of mechanical ventilation were not associated with mortality of trauma patients without acute respiratory distress syndrome.
Abstract
Rev Bras Ter Intensiva. 2016;28(1):27-32
DOI 10.5935/0103-507X.20160010
To determine the efficacy of lung hyperinflation maneuvers via a mechanical ventilator compared to isolated tracheal aspiration for removing secretions, normalizing hemodynamics and improving lung mechanics in patients on mechanical ventilation.
This was a randomized crossover clinical trial including patients admitted to the intensive care unit and on mechanical ventilation for more than 48 hours. Patients were randomized to receive either isolated tracheal aspiration (Control Group) or lung hyperinflation by mechanical ventilator (MVH Group). Hemodynamic and mechanical respiratory parameters were measured along with the amount of aspirated secretions.
A total of 50 patients were included. The mean age of the patients was 44.7 ± 21.6 years, and 31 were male. Compared to the Control Group, the MVH Group showed greater aspirated secretion amount (3.9g versus 6.4g, p = 0.0001), variation in mean dynamic compliance (-1.3 ± 2.3 versus -2.9 ± 2.3; p = 0.008), and expired tidal volume (-0.7 ± 0.0 versus -54.1 ± 38.8, p = 0.0001) as well as a significant decrease in peak inspiratory pressure (0.2 ± 0.1 versus 2.5 ± 0.1; p = 0.001).
In the studied sample, the MVH technique led to a greater amount of aspirated secretions, significant increases in dynamic compliance and expired tidal volume and a significant reduction in peak inspiratory pressure.
Abstract
Rev Bras Ter Intensiva. 2016;28(1):27-32
DOI 10.5935/0103-507X.20160010
To determine the efficacy of lung hyperinflation maneuvers via a mechanical ventilator compared to isolated tracheal aspiration for removing secretions, normalizing hemodynamics and improving lung mechanics in patients on mechanical ventilation.
This was a randomized crossover clinical trial including patients admitted to the intensive care unit and on mechanical ventilation for more than 48 hours. Patients were randomized to receive either isolated tracheal aspiration (Control Group) or lung hyperinflation by mechanical ventilator (MVH Group). Hemodynamic and mechanical respiratory parameters were measured along with the amount of aspirated secretions.
A total of 50 patients were included. The mean age of the patients was 44.7 ± 21.6 years, and 31 were male. Compared to the Control Group, the MVH Group showed greater aspirated secretion amount (3.9g versus 6.4g, p = 0.0001), variation in mean dynamic compliance (-1.3 ± 2.3 versus -2.9 ± 2.3; p = 0.008), and expired tidal volume (-0.7 ± 0.0 versus -54.1 ± 38.8, p = 0.0001) as well as a significant decrease in peak inspiratory pressure (0.2 ± 0.1 versus 2.5 ± 0.1; p = 0.001).
In the studied sample, the MVH technique led to a greater amount of aspirated secretions, significant increases in dynamic compliance and expired tidal volume and a significant reduction in peak inspiratory pressure.
Abstract
Rev Bras Ter Intensiva. 2013;25(1):32-38
DOI 10.1590/S0103-507X2013000100007
OBJECTIVES: Identify patients at risk for intensive care unit readmission, the reasons for and rates of readmission, and mortality after their stay in the intensive care unit; describe the sensitivity and specificity of the Stability and Workload Index for Transfer scale as a criterion for discharge from the intensive care unit. METHODS: Adult, critical patients from intensive care units from two public hospitals in Porto Alegre, Brazil, comprised the sample. The patients' clinical and demographic characteristics were collected within 24 hours of admission. They were monitored until their final outcome on the intensive care unit (death or discharge) to apply the Stability and Workload Index for Transfer. The deaths during the first intensive care unit admission were disregarded, and we continued monitoring the other patients using the hospitals' electronic systems to identify the discharges, deaths, and readmissions. RESULTS: Readmission rates were 13.7% in intensive care unit 1 (medical-surgical, ICU1) and 9.3% in intensive care unit 2 (trauma and neurosurgery, ICU2). The death rate following discharge was 12.5% from ICU1 and 4.2% from ICU2. There was a statistically significant difference in Stability and Workload Index for Transfer (p<0.05) regarding the ICU1 patients' outcome, which was not found in the ICU2 patients. In ICU1, 46.5% (N=20) of patients were readmitted very early (within 48 hours of discharge). Mortality was high among those readmitted: 69.7% in ICU1 and 48.5% in ICU2. CONCLUSIONS: The Stability and Workload Index for Transfer scale showed greater efficacy in identifying patients more prone to readmission and death following discharge from a medical-surgical intensive care unit. The patients' intensive care unit readmission during the same hospitalization resulted in increased morbidity, mortality, length of stay, and total costs.
Abstract
Rev Bras Ter Intensiva. 2013;25(1):32-38
DOI 10.1590/S0103-507X2013000100007
OBJECTIVES: Identify patients at risk for intensive care unit readmission, the reasons for and rates of readmission, and mortality after their stay in the intensive care unit; describe the sensitivity and specificity of the Stability and Workload Index for Transfer scale as a criterion for discharge from the intensive care unit. METHODS: Adult, critical patients from intensive care units from two public hospitals in Porto Alegre, Brazil, comprised the sample. The patients' clinical and demographic characteristics were collected within 24 hours of admission. They were monitored until their final outcome on the intensive care unit (death or discharge) to apply the Stability and Workload Index for Transfer. The deaths during the first intensive care unit admission were disregarded, and we continued monitoring the other patients using the hospitals' electronic systems to identify the discharges, deaths, and readmissions. RESULTS: Readmission rates were 13.7% in intensive care unit 1 (medical-surgical, ICU1) and 9.3% in intensive care unit 2 (trauma and neurosurgery, ICU2). The death rate following discharge was 12.5% from ICU1 and 4.2% from ICU2. There was a statistically significant difference in Stability and Workload Index for Transfer (p<0.05) regarding the ICU1 patients' outcome, which was not found in the ICU2 patients. In ICU1, 46.5% (N=20) of patients were readmitted very early (within 48 hours of discharge). Mortality was high among those readmitted: 69.7% in ICU1 and 48.5% in ICU2. CONCLUSIONS: The Stability and Workload Index for Transfer scale showed greater efficacy in identifying patients more prone to readmission and death following discharge from a medical-surgical intensive care unit. The patients' intensive care unit readmission during the same hospitalization resulted in increased morbidity, mortality, length of stay, and total costs.
Abstract
Rev Bras Ter Intensiva. 2013;25(2):93-98
DOI 10.5935/0103-507X.20130019
OBJECTIVE: 1) To evaluate the functional independence measures immediately after discharge from an intensive care unit and to compare these values with the FIMs 30 days after that period. 2) To evaluate the possible associated risk factors. METHODS: The present investigation was a prospective cohort study that included individuals who were discharged from the intensive care unit and underwent physiotherapy in the unit. Functional independence was evaluated using the functional independence measure immediately upon discharge from the intensive care unit and 30 days thereafter via a phone call. The patients were admitted to the Hospital Santa Clara intensive care unit during the period from May 2011 to August 2011. RESULTS: During the predetermined period of data collection, 44 patients met the criteria for inclusion in the study. The mean age of the patients was 55.4±10.5 years. Twenty-seven of the subjects were female, and 15 patients were admitted due to pulmonary disease. The patients exhibited an functional independence measure of 84.1±24.2. When this measure was compared to the measure at 30 days after discharge, there was improvement across the functional independence variables except for that concerned with sphincter control. There were no significant differences when comparing the gender, age, clinical diagnosis, length of stay in the intensive care unit, duration of mechanical ventilation, and the presence of sepsis during this period. CONCLUSION: Functional independence, as evaluated by the functional independence measure scale, was improved at 30 days after discharge from the intensive care unit, but it was not possible to define the potentially related factors.
Abstract
Rev Bras Ter Intensiva. 2013;25(2):93-98
DOI 10.5935/0103-507X.20130019
OBJECTIVE: 1) To evaluate the functional independence measures immediately after discharge from an intensive care unit and to compare these values with the FIMs 30 days after that period. 2) To evaluate the possible associated risk factors. METHODS: The present investigation was a prospective cohort study that included individuals who were discharged from the intensive care unit and underwent physiotherapy in the unit. Functional independence was evaluated using the functional independence measure immediately upon discharge from the intensive care unit and 30 days thereafter via a phone call. The patients were admitted to the Hospital Santa Clara intensive care unit during the period from May 2011 to August 2011. RESULTS: During the predetermined period of data collection, 44 patients met the criteria for inclusion in the study. The mean age of the patients was 55.4±10.5 years. Twenty-seven of the subjects were female, and 15 patients were admitted due to pulmonary disease. The patients exhibited an functional independence measure of 84.1±24.2. When this measure was compared to the measure at 30 days after discharge, there was improvement across the functional independence variables except for that concerned with sphincter control. There were no significant differences when comparing the gender, age, clinical diagnosis, length of stay in the intensive care unit, duration of mechanical ventilation, and the presence of sepsis during this period. CONCLUSION: Functional independence, as evaluated by the functional independence measure scale, was improved at 30 days after discharge from the intensive care unit, but it was not possible to define the potentially related factors.
