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You searched for:"Silvia Renata Rezek Juliano"

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  • Artigos originais

    Implementation, assessment and comparison of the T-Tube and pressure-support weaning protocols applied to the intensive care unit patients who had received mechanical ventilation for more than 48 hours

    Rev Bras Ter Intensiva. 2007;19(1):31-37

    Abstract

    Artigos originais

    Implementation, assessment and comparison of the T-Tube and pressure-support weaning protocols applied to the intensive care unit patients who had received mechanical ventilation for more than 48 hours

    Rev Bras Ter Intensiva. 2007;19(1):31-37

    DOI 10.1590/S0103-507X2007000100004

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    BACKGROUND AND OBJECTIVES: Mechanical ventilation incurs significant morbidity and mortality, weaning intensive care unit patients is highly desirable, although it is usuallyconducted in an empirical manner. Thus, this article assessed a weaning protocol implementation and compared two different methods. METHODS: It was carried out a study involving 120 patients who had received mechanical ventilation for more than 48 hours. These patients were randomlyassigned to undergo one of two weaning techniques: pressure-supportventilation + PEEP (PSP) technique, which was applied to the patients in equal days, forming the PSP group (PSPG) and the T-tube method (TT), applied in odd days and forming the TT group (TTG). Standardized protocols were followedfor each technique RESULTS: The patients response to extubation revealed similar progress in both PSP and TT groups, but after the Chi-square statistical test, the benefits of using a weaning protocol was clear. One hundred nine (90.83%) of all patients, had a successful weaning and any noninvasive ventilation type was needed in a span time of 24 hours after extubation, and only eleven (9.17%), had an unsuccessful weaning. CONCLUSIONS: Although this study didn't show any difference between the two methods applied, we could conclude that, the implementation of standardized weaning protocols can substantially decrease the patient's reintubation rate, promoting a downward trend in mortality and morbidity for these patients and shortening their hospital and intensive care units length of stay.

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    Implementation, assessment and comparison of the T-Tube and pressure-support weaning protocols applied to the intensive care unit patients who had received mechanical ventilation for more than 48 hours
  • Measurement of tube cuff pressure levels in intensive care unit: considerations on the benefits of training

    Rev Bras Ter Intensiva. 2007;19(3):317-321

    Abstract

    Measurement of tube cuff pressure levels in intensive care unit: considerations on the benefits of training

    Rev Bras Ter Intensiva. 2007;19(3):317-321

    DOI 10.1590/S0103-507X2007000300008

    Views2

    BACKGROUND AND OBJECTIVES: The tube cuff pressure directly transmitted on the tracheal wall in an irregular form can cause injuries and lead to bronchoaspiration. The aim of this study was to demonstrate that the implementation of routine tube cuff pressure measurements result in a reliable control to maintain the measurements within the parameters considered safe, thus preventing the described complications. METHODS: A total of 3,195 tube cuff measurements were obtained from 1,194 male and female patients admitted at the Intensive Care Unit (ICU) and Coronary Unit (CU), who were undergoing mechanical ventilation with endotracheal prosthesis and tracheotomy cannula, during the morning and afternoon periods. RESULTS: From March to August 2005 the follow-up of the measurements obtained by the physical therapy professionals was carried out and it was observed that the measurements were irregular, on average, in 80% of the cases. Thus, a training program was established, which was focused on the Nursing Teams of the ICU and CU, consisting in providing directions for the adequate procedures performed at the bedside (in loco training). The training procedures were carried out at two different periods (morning and afternoon) in order to include the whole team. CONCLUSIONS: It is suggested that it is necessary to monitor tube cuff pressure through the implementation of routine measurements in the morning, afternoon and evening periods as a prophylactic measure, in order to prevent the possible complications of tracheal prosthesis balloon pressure.

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    Measurement of tube cuff pressure levels in intensive care unit: considerations on the benefits of training

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