Respiratory mechanics and CT measure-under the same term, "recruitment"-two different entities. The respiratory mechanics-based methods include gas entering in already open pulmonary units that improve their mechanical properties at higher PEEP. Consequently, they can be used to assess the overall improvement of inflation. The CT scan measures the amount of collapsed tissue that regains inflation. Clinical trial registered with www.clinicaltrials.gov (NCT00759590).

Clinicaltrials.gov identifier: NCT01670747 ( www.clinicaltrials.gov ).

No abstract

ResumoCom a presente pesquisa, propôs-se uma análise acerca da temática saberes de professores, especificamente a investigação sobre quais são os saberes que podem ser mobilizados/estimulados por meio da Metodologia da Problematização (M.P.) com o Arco de Maguerez (que se constitui com cinco etapas: observação da realidade e definição do problema, pontos-chave, teorização, hipóteses de solução e aplicação à realidade), em seus participantes. Utilizou-se a pesquisa exploratório-descritiva, por meio da literatura que trata de saberes de professores e da Metodologia da Problematização. A pesquisa possibilitou ampliar a compreensão quanto ao grande potencial pedagógico dessa metodologia enquanto método de ensino, de pesquisa ou outras aplicações, como na orientação de Trabalho de Conclusão de Curso -TCC -, pelos saberes que foram associados a cada uma de suas etapas (saberes pedagógicos, curriculares, disciplinares, profissionais, experienciais, entre outros). Reforçou o aprendizado anterior acerca desta temática, tanto pelo processo científico, quanto pela análise crítica desenvolvida a partir do referencial teórico utilizado. Desse modo, ampliou-se a visão de que a M.P. pode ser utilizada na formação de professores, como um processo contínuo que pode incluir pesquisas acerca da docência, como um caminho que estimula a utilização e a aquisição de diferentes saberes, o que permite uma formação ampliada desse profissional, além de prepará-lo para uma ação de transformação da realidade educacional da qual faz parte. Palavras-chave: Metodologia da problematização. Saberes de professores. Formação de professores. AbstractThe purpose of this research is to accomplish an analysis of the theme "teachers' knowledge", more specifically a research on which knowledge can be dealt with/stimulated by the Problematization Methodology (P.M.) and the Maguerez' Arch in the participants, following five stages: observation of reality and definition of problem, key points, theorization, solution hypothesis and application in reality. The exploratory-descriptive research was based the literature that deals with teachers' knowledge as well as the Problematization Methodology. This research made it possible to broaden the understanding of the great pedagogical potential of this methodology while a methods for teaching, research or other uses, as when supervising an end-of-term paper (TCC), by the knowledge that was associated to each of its stages (pedagogical, curricular, discipline, professional, experiential, knowledge, among others). It strengthened the previous knowledge on this theme, not only through the scientific process but also through the critical analysis developed, based on the theoretical framework that was used. Thus it was broadened the idea that the Problematization Methodology can be used in the teachers'

Lung ultrasound is increasingly used in emergency departments, medical wards, and critical care units—adult, pediatric, and neonatal. In vitro and in vivo studies show that the number and type of artifacts visualized change with lung density. This has led to the idea of a quantitative lung ultrasound approach, opening up new prospects for use not only as a diagnostic but also as a monitoring tool. Consequently, the multiple scoring systems proposed in the last few years have different technical approaches and specific clinical indications, adaptable for more or less time-dependent patients. However, multiple scoring systems may generate confusion among physicians aiming at introducing lung ultrasound in their clinical practice. This review describes the various lung ultrasound scoring systems and aims to clarify their use in different settings, focusing on technical aspects, validation with reference techniques, and clinical applications.

IntroductionPatients with acute respiratory failure requiring respiratory support with invasive mechanical ventilation while awaiting lung transplantation are at a high risk of death. Extracorporeal membrane oxygenation (ECMO) has been proposed as an alternative bridging strategy to mechanical ventilation. The aim of this study was to assess the current evidence regarding how the ECMO bridge influences patients’ survival and length of hospital stay.MethodsWe performed a systematic review by searching PubMed, EMBASE and the bibliographies of retrieved articles. Three reviewers independently screened citation titles and abstracts and agreement was reached by consensus. We selected studies enrolling patients who received ECMO with the intention to bridge lung transplant. We included randomized controlled trials (RCTs), case–control studies and case series with ten or more patients. Outcomes of interest included survival and length of hospital stay. Quantitative data summaries were made when feasible.ResultsWe identified 82 studies, of which 14 were included in the final analysis. All 14 were retrospective studies which enrolled 441 patients in total. Because of the broad heterogeneity among the studies we did not perform a meta-analysis. The mortality rate of patients on ECMO before lung transplant and the one-year survival ranged from 10% to 50% and 50% to 90%, respectively. The intensive care and hospital length of stay ranged between a median of 15 to 47 days and 22 to 47 days, respectively. There was a general paucity of high-quality data and significant heterogeneity among studies in the enrolled patients and technology used, which confounded analysis.ConclusionsIn most of the studies, patients on ECMO while awaiting lung transplantation also received invasive mechanical ventilation. Therefore, whether ECMO as an alternative, rather than an adjunction, to invasive mechanical ventilation is a better bridging strategy to lung transplantation still remains an unresolved issue. ECMO support as a bridge for these patients could provide acceptable one-year survival. Future studies are needed to investigate ECMO as part of an algorithm of care for patients with end-stage lung disease.

Based on our observations, elastance-derived transpulmonary pressure can be considered to be an adequate surrogate of the release-derived transpulmonary pressure, while the release-derived and directly measured end-expiratory transpulmonary pressure are not related.

Two weeks later, 25 patients presented with AF. Spectral analysis of HRV revealed that patients wi