Impact of the open and closed tracheal suctioning system on the incidence of mechanical ventilationassociated pneumonia: literature review Impacto do sistema de aspiração traqueal aberto e fechado na incidência de pneumonia associada à ventilação mecânica: revisão de literatura
Humanization of physiotherapy care: study with patients post-stay in the intensive care unit Humanização da assistência de fisioterapia: estudo com pacientes no período pós-internação em unidade de terapia intensiva
ObjectiveTo assess the oxygenation behavior and ventilatory mechanics after hemodialysis in
patients under ventilatory support. MethodsThe present study was performed in the general intensive care unit of a tertiary
public hospital. Patients over 18 years of age under mechanical ventilation and in
need of dialysis support were included. Each patient was submitted to 2
evaluations (pre- and post-dialysis) regarding the cardiovascular and ventilatory
parameters, the ventilatory mechanics and a laboratory evaluation. ResultsEighty patients with acute or chronic renal failure were included. The analysis of
the ventilatory mechanics revealed a reduction in the plateau pressure and an
increased static compliance after dialysis that was independent of a reduction in
blood volume. The patients with acute renal failure also exhibited a reduction in
peak pressure (p=0.024) and an increase in the dynamic compliance (p=0.026),
whereas the patients with chronic renal failure exhibited an increase in the
resistive pressure (p=0.046) and in the resistance of the respiratory system
(p=0.044). The group of patients with no loss of blood volume after dialysis
exhibited an increase in the resistive pressure (p=0.010) and in the resistance of
the respiratory system (p=0.020), whereas the group with a loss of blood volume
>2,000mL exhibited a reduction in the peak pressure (p=0.027). No changes in
the partial pressure of oxygen in arterial blood (PaO2) or in the
PaO2/the fraction of inspired oxygen
(PaO2/FiO2) ratio were observed. ConclusionHemodialysis was able to alter the mechanics of the respiratory system and
specifically reduced the plateau pressure and increased the static compliance
independent of a reduction in blood volume.
Este estudo objetivou investigar o estado funcional e sua associação com o nível glicêmico, uso da prótese, tipo e nível da amputação. Trata-se de um estudo transversal realizado com 63 idosos com amputação de membros inferiores por diabetes, atendidos no Centro Estadual de Prevenção e Reabilitação de Deficiências, Estado da Bahia. Para coleta de dados, utilizou-se um questionário padronizado. Calculou-se a prevalência de dependência moderada/grave (índice de Barthel <70) e como medida de associação utilizou-se o OR ajustado e respectivo intervalo de confiança a 95%. Verificou-se que idosos com amputação abaixo do joelho apresentaram média do Barthel significativamente menor. Já aqueles com nível glicêmico elevado apresentaram chance 8.4 vezes maior de dependência moderada/grave quando comparados àqueles com nível glicêmico adequado. Os achados deste estudo mostram que dentre as estratégias adotadas no manejo deste paciente, é importante incluir a avaliação do estado funcional e assinalam a influência que o controle metabólico, o tipo e nível da amputação exercem sobre a condição de saúde destes.
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