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Role of interleukin-3 as a prognostic marker in septic patients
Conclusion: Higher levels of IL-3 are shown to be independently associated with hospital mortality in septic patients but with poor clinical performance. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - January 17, 2019 Category: Intensive Care Source Type: research

Risk factors for vascular catheter-related bloodstream infections in pediatric intensive care units
Conclusion: A longer duration of central venous catheter use and the use of more than one central venous catheter at once were the main risk factors for CLABSI in pediatric intensive care units. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - January 17, 2019 Category: Intensive Care Source Type: research

Association between pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score and mortality in a pediatric intensive care unit: a retrospective study
Conclusion: In this study, the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score proved to be a useful tool for the early identification of severely ill children with acute kidney injury, showing an association with mortality. We thus suggest its use for pediatric intensive care unit patient admission. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - January 17, 2019 Category: Intensive Care Source Type: research

Use of vasopressin in the treatment of refractory septic shock
Conclusion: The series evaluated had high mortality in the first 72 hours of treatment with vasopressin. The use of vasopressin in patients who are refractory to norepinephrine had little or no impact on mortality. It was not possible to exclude the possibility that the high mortality in the present study was linked to the relatively late onset (after established refractoriness of norepinephrine) of vasopressin; this hypothesis should be further evaluated in a randomized study. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - January 17, 2019 Category: Intensive Care Source Type: research

An electronic warning system helps reduce the time to diagnosis of sepsis
Conclusion: Electronic systems help reduce the triage-to-diagnosis time and diagnosis-to-antibiotic time in patients with sepsis. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - January 17, 2019 Category: Intensive Care Source Type: research

Quality of life after intensive care unit: a multicenter cohort study protocol for assessment of long-term outcomes among intensive care survivors in Brazil
Discussion: The present study has the potential to contribute to current knowledge of the prevalence and factors associated with postintensive care syndrome among adult intensive care survivors in Brazil. In addition, an association might be established between postintensive care syndrome and health-related quality of life. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - January 17, 2019 Category: Intensive Care Source Type: research

Sepsis is an important healthcare burden in Latin America: a call to action!
(Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - January 17, 2019 Category: Intensive Care Source Type: research

Use of topical glutamine as an adjuvant for the treatment of oral ulcers
We report the case of a patient with severe thrombocytopenia whose thromboelastometry showed clot strength that was compensated for by the increase in plasma fibrinogen levels as an acute phase reactant of septic patients. Here, we report a case of a 62-year-old female diagnosed with bone marrow aplasia admitted in the intensive care unit with septic shock and severe thrombocytopenia. During the first 24 hours in the intensive care unit, she presented acute respiratory insufficiency and circulatory shock. The use of invasive mechanical ventilation and norepinephrine was required. Her chest X-ray showed bilateral lung injur...
Source: Revista Brasileira de Terapia Intensiva - October 11, 2018 Category: Intensive Care Source Type: research

Reply to: The Epimed Monitor ICU Database®: a cloud-based national registry for adult intensive care unit patients in Brazil
We report the case of a patient with severe thrombocytopenia whose thromboelastometry showed clot strength that was compensated for by the increase in plasma fibrinogen levels as an acute phase reactant of septic patients. Here, we report a case of a 62-year-old female diagnosed with bone marrow aplasia admitted in the intensive care unit with septic shock and severe thrombocytopenia. During the first 24 hours in the intensive care unit, she presented acute respiratory insufficiency and circulatory shock. The use of invasive mechanical ventilation and norepinephrine was required. Her chest X-ray showed bilateral lung injur...
Source: Revista Brasileira de Terapia Intensiva - October 11, 2018 Category: Intensive Care Source Type: research

Compensatory effect of fibrinogen in a patient with bone marrow aplasia, septic shock, and severe thrombocytopenia guided by thromboelastometry: a case report
We report the case of a patient with severe thrombocytopenia whose thromboelastometry showed clot strength that was compensated for by the increase in plasma fibrinogen levels as an acute phase reactant of septic patients. Here, we report a case of a 62-year-old female diagnosed with bone marrow aplasia admitted in the intensive care unit with septic shock and severe thrombocytopenia. During the first 24 hours in the intensive care unit, she presented acute respiratory insufficiency and circulatory shock. The use of invasive mechanical ventilation and norepinephrine was required. Her chest X-ray showed bilateral lung injur...
Source: Revista Brasileira de Terapia Intensiva - October 11, 2018 Category: Intensive Care Source Type: research

Non-invasive hemodynamic evaluation by Doppler echocardiography
RESUMO A abordagem do doente hemodinamicamente inst ável constitui um desafio diagnóstico e terapêutico. A estabilização do doente deve ser rápida e eficaz, não existindo muita margem para erro. Esta estreita janela de intervenção faz com que seja necessário recorrer a métodos de avaliação hemodinâmica rápidos e precisos. A ecocardiogr afia constitui o método de eleição para a avaliação, à beira do leito, do doente em choque circulatório. De fato, foram os médicos intensivistas que cedo reconheceram as potencialidades do ecocardiograma com estudo Doppler para a abordagem inicial do doente em falênci...
Source: Revista Brasileira de Terapia Intensiva - October 11, 2018 Category: Intensive Care Source Type: research

Early versus delayed initiation of renal replacement therapy for acute kidney injury: an updated systematic review, meta-analysis, meta-regression and trial sequential analysis of randomized controlled trials
Conclusion: Early initiation of renal replacement therapy is not associated with improved survival. However, the quality of the current evidence is low, and the criteria used for -early- and -delayed- initiation of renal replacement therapy are too heterogeneous among studies. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 11, 2018 Category: Intensive Care Source Type: research

Effectiveness of rapid response teams in reducing intrahospital cardiac arrests and deaths: a systematic review and meta-analysis
Conclusion: We conclude that rapid response teams may reduce in-hospital mortality and cardiac arrests, although the quality of evidence for both outcomes is low. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 11, 2018 Category: Intensive Care Source Type: research

Use of dietary fibers in enteral nutrition of critically ill patients: a systematic review
RESUMO Para atender as necessidades nutricionais de pacientes admitidos às unidades de terapia intensiva, é necessário estabelecer um plano dietético. As complicações associadas com a nutrição enteral administrada por tubo não são incomuns e podem reduzir o fornecimento das necessidades nutricionais a pacientes internados na unidade de terapia intensiva. Encon tram-se em andamento pesquisas relativas a osmolaridade, gorduras, intensidade calórica e conteúdo de fibras das fórmulas, e muitos estudos têm focado na tolerabilidade ao conteúdo de fibras ou na redução de sintomas. Conduzimos uma revisão sistemá...
Source: Revista Brasileira de Terapia Intensiva - October 11, 2018 Category: Intensive Care Source Type: research

Planning and understanding the intensive care network in the State of Rio de Janeiro (RJ), Brazil: a complex societal problem
Conclusion: The queue should be treated as a complex societal problem with a multifactorial origin requiring integrated solutions. Improving intensive care unit protocols and reengineering the general wards may decrease the length of stay. It is essential to redefine and consolidate the regulatory centers to organize the queue and provide available resources in a timely manner, by using priority criteria, working with stakeholders to guarantee clinical governance and network organization. (Source: Revista Brasileira de Terapia Intensiva)
Source: Revista Brasileira de Terapia Intensiva - October 11, 2018 Category: Intensive Care Source Type: research