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Impact of fast-track management on adult cardiac surgery: clinical and hospital outcomes
Conclusion: Patients undergoing fast-track management with extubation within 6 hours had shorter stays in the intensive care unit without increasing postoperative complications and death. Patients extubated in the operating room had a shorter hospital stay and a shorter stay in the intensive care unit but showed an increase in the frequency of reintubation and postoperative complications. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Evaluation of pulmonary B lines by different intensive care physicians using bedside ultrasonography: a reliability study
Conclusion: The possible limitation of an examiner-dependent effect on lung ultrasounds was not found in this study, suggesting the good reproducibility of this diagnostic modality at the bedside. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Atelectasis and lung changes in preterm neonates in the neonatal period: a blind radiological report and clinical findings
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. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

A past medical history of heart failure is associated with less fluid therapy in septic patients
Conclusion: Septic patients with a past history of heart failure received 1L less IV fluids in the first 24 hours with no difference in mortality. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Noninvasive ventilation as the first choice of ventilatory support in children
Conclusion: A high rate of effectiveness was found for the use of noninvasive ventilation for acute episodes of respiratory failure. A higher PRISM score on admission, comorbidities associated with respiratory symptoms and oxygen use ≥ 40% were independent factors related to noninvasive ventilation failure. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

High nutritional risk is associated with unfavorable outcomes in patients admitted to an intensive care unit
Conclusion: In critically ill patients, high nutritional risk was positively associated with an increased risk of clinical outcomes including hospital death. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Checklist for managing critical patients' daily awakening
Conclusion: The instrument proposed in the study exhibited content validity for most of its items and emerges as a practical strategy for the management of the daily interruption of sedation of critical patients. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Respiratory distress syndrome: influence of management on the hemodynamic status of ≤ 32-week preterm infants in the first 24 hours of life
Conclusion: In ≤ 32-week newborns under invasive mechanical ventilation, increases in the mean airway pressure and number of surfactant doses are correlated with the worsening of early cardiac function. Therefore, more aggressive management of respiratory distress syndrome may contribute to the hemodynamic instability of these patients. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Update of the diagnostic criteria of brain death: application and training of physicians
Conclusions: Difficulties in the application of brain death criteria were identified by a significant portion of the sample. However, among other factors, more years of training and a greater number of initiated brain death protocols were associated with greater ease in the application of brain death criteria according to the guidelines provided in Resolution 2,173 of the Federal Council of Medicine. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Autonomic responses of premature newborns to body position and environmental noise in the neonatal intensive care unit
Conclusion: The prone position and manual restraint position increased both parasympathetic activity and the complexity of autonomic adjustments in comparison to the supine position, even in the presence of higher environmental noise than the recommended level, which tends to increase sympathetic activity. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial
Conclusion: Ventilator hyperinflation promoted increased compliance associated with a transient increase in airway resistance and peak expiratory flow, with reduction after aspiration. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Activation of extracorporeal membrane oxygenation: a therapeutic approach to be considered
Conclusion: Nontransporting emergency medical service vehicles have the potential for inclusion in the extracorporeal membrane oxygenation network of the study area. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

No one is better than all together: the role of networks in pediatric intensive care
(Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 15, 2019 Category: Intensive Care Source Type: research

Reply to: Long-term psychological outcome after discharge from intensive care
RESUMO O traumatismo card íaco é comum em acidentes com veículos automotores. Uma mulher com 50 anos de idade foi transportada para nosso hospital após sofrer múltiplos traumatismos em um acidente de automóvel quando dirigia em alta velocidade. Após admissão à unidade de terapia intensiva, uma ultrassonografia cardí aca revelou ruptura traumática de músculo papilar da valva tricúspide e forame oval patente, enquanto se observou, no exame físico, o sinal de Lancisi. Foi realizado tratamento cirúrgico com anuloplastia da valva e fechamento do forame oval patente; durante o ato cirúrgico, diagnosticou-se rup t...
Source: Revista Brasileira de Terapia Intensiva - June 27, 2019 Category: Intensive Care Source Type: research

To: Perfusion index for assessing microvascular reactivity in septic shock after fluid resuscitation
RESUMO O traumatismo card íaco é comum em acidentes com veículos automotores. Uma mulher com 50 anos de idade foi transportada para nosso hospital após sofrer múltiplos traumatismos em um acidente de automóvel quando dirigia em alta velocidade. Após admissão à unidade de terapia intensiva, uma ultrassonografia cardí aca revelou ruptura traumática de músculo papilar da valva tricúspide e forame oval patente, enquanto se observou, no exame físico, o sinal de Lancisi. Foi realizado tratamento cirúrgico com anuloplastia da valva e fechamento do forame oval patente; durante o ato cirúrgico, diagnosticou-se rup t...
Source: Revista Brasileira de Terapia Intensiva - June 27, 2019 Category: Intensive Care Source Type: research