Trata-se de um estudo histórico que tem como objetivo descrever os primórdios da assistência aos recém-nascidos, no exterior e no Brasil, no período de 1870 a 1903. As fontes primárias são artigos existentes na Fundação Biblioteca Nacional. As fontes secundárias são estudos pertinentes à temática. Com a finalidade de manter os prematuros aquecidos, no final do século XIX, foram criadas as primeiras incubadoras. No Brasil, as incubadoras Lion chegaram no início do século XX (1903). O uso das incubadoras e a especificidade dos cuidados aos recém-nascidos são marcos relevantes para o desenvolvimento da neonatologia. PALAVRAS-CHAVES: Enfermagem; Neonatologia; História da Enfermagem. SUMMARY:It is a historical study that has as objective to describe the early days of the assistance to the newborn babies in foreign countries and in Brazil, from 1870 to 1903. The primary sources are existing articles in the Foundation National Library. The secondary sources are pertinent studies to the thematic one. With the purpose to keep warm the premature babies, in the end of XIX century were created the first incubator. In Brazil, the "Lion" new-born babies arrived in the beginning of XX century (1903). The use of the new born babies and the peculiarities of the cares to the new-born babies are Importants landmarks for the development of the neonatology.

O estudo tem como objetivo descrever os cuidados de enfermagem ao recém-nascido e analisar as modificações na assistência de enfermagem ao recém-nascido no período de 1937 a 1979. Trata-se de um estudo histórico. As fontes primárias são quatorze artigos publicados na Revista Brasileira de Enfermagem no período em questão e as secundárias são os livros e periódicos nacionais e internacionais referentes à história da pediatria e da neonatologia. Evidencia-se, nesse período, a descrição detalhada dos cuidados diretos (básicos e específicos) e indiretos prestados ao recém-nascido pela equipe de enfermagem. Entre os cuidados diretos básicos, destacam-se: higiene corporal e cuidado com o coto umbilical. Os cuidados diretos específicos são: infecções e síndromes respiratórias. Os cuidados indiretos estão relacionados com os materiais e equipamentos. Conclui-se que o discurso oficial das enfermeiras estava voltado para a sistematização dos cuidados de enfermagem aos recém-nascidos, como precursora dos cuidados intensivos neonatais.

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Background: Fluid overload is a risk factor for morbidity, mortality, and prolonged ventilation time after surgery. Patients on maintenance hemodialysis might be at higher risk. We hypothesized that fluid accumulation would be directly associated with extended ventilation time in patients on hemodialysis, as compared to patients with chronic kidney disease not on dialysis (CKD3-4) and patients with normal renal function (reference group). Methods: This is a prospective observational study that included patients submitted to isolated and elective coronary artery bypass surgery, divided in 3 groups according to time on mechanical ventilation: < 24 h, 24-48 h and > 48 h. The same observer followed patients daily from the surgery to the hospital discharge. Cumulative fluid balance was defined as the sum of daily fluid balance over the first 5 days following surgery. Results: Patients requiring more than 48 h of ventilation (5.3%) had a lower estimated glomerular filtration rate, were more likely to be on maintenance dialysis, had longer anesthesia time, needed higher dobutamine and noradrenaline infusion following surgery, and had longer hospitalization stay. Multivariate analysis revealed that the fluid accumulation, scores of sequential organ failure assessment in the day following surgery, and the renal function (normal, chronic kidney disease not on dialysis and maintenance hemodialysis) were independently associated with time in mechanical ventilation. Among patients on hemodialysis, the time from the surgery to the first hemodialysis session also accounted for the time on mechanical ventilation. Conclusions: Fluid accumulation is an important risk factor for lengthening mechanical ventilation, particularly in patients on hemodialysis. Future studies are warranted to address the ideal timing for initiating dialysis in this scenario in an attempt to reduce fluid accumulation and avoid prolonged ventilation time and hospital stay.

Background and objectives Chronic kidney disease (CKD) is considered a world health problem and is associated with a high mortality rate, particularly among elderly patients. With the aging population, there has been an increase in elderly patients starting hemodialysis. Elderly patients are subject to a high burden of comorbidities and the risk of falls and fractures is a concern since it can lead to hospitalization and death. Falls occur as a consequence of clinical pathologies and are aggravated by hemodialysis‐associated hypotension. Sarcopenia, defined as the loss of muscle mass and strength that occurs with aging is commonly seen in these patients. Measurement of calf circumference (CC) is an easy and not expensive tool to assess muscle mass. The objective of this study was to test the association between CC, a marker of sarcopenia, and the risk of falls and fractures in elderly patients on hemodialysis. Methods This is a cross‐sectional study that included clinically stable patients ≥ 65 years, on maintenance hemodialysis. The same observer measured the calf circumference in the non‐dominant leg. Clinical and biochemical data were collected from the charts. Results Preliminary results of 96 patients (age 73 ± 6 years, % mean) showed a CC of 32.7 ±3.5 and 31.5 ± 4.6 cm in men and women, respectively, p=0,143). History of falls was found in 20 patients (40.6% with low CC vs. 36.8% with normal CC, p=0.789). Patients with low CC according to gender presented lower body mass index (p=0.0001) and had lower weight gain between dialysis sessions (p=0.008). They did not differ from patients with normal CC according to age, gender, race, blood pressure, serum albumin, and presence of comorbidities such as hypertension, diabetes, and congestive heart failure. Conclusions Although the measurement of CC did not predict falls in elderly patients on hemodialysis, it did identify patients with low body mass index, which is probably related to sarcopenia. Further studies are necessary to definitely conclude the lack of association between CC and falls.

Background Fluid overload is a risk factor for morbidity, mortality, and prolonged ventilation time after surgery. Patients on maintenance hemodialysis might be at higher risk. We hypothesized that fluid accumulation would be directly associated with extended ventilation time in patients on hemodialysis, as compared to patients with chronic kidney disease not on dialysis (CKD3-4) and patients with normal renal function (reference group).Methods this is a prospective observational study that included consecutive patients submitted to an isolated and elective coronary artery bypass surgery classified as reference (N=167, normal renal function), CKD3-4 (N=84, estimated glomerular filtration rate 30-60ml/min/1.73m 2 ), and hemodialysis (N=31, maintenance hemodialysis) groups. The same observer followed patients daily from the surgery to the hospital discharge.Results Fluid accumulation correlated with time on mechanical ventilation in patients on hemodialysis (r=0.627, p=0.003), but not in the CKD3-4 group (r=-0.068, p=0.652) and in the reference group (r=-0.085, p=0.363). Multivariate analysis revealed that the fluid accumulation, scores of sequential organ failure assessment-SOFA in the day following surgery, and the group according to renal function were independently associated with ventilation time. Furthermore, in patients on hemodialysis, the time between surgery and the first hemodialysis also accounted for the time on mechanical ventilation.Conclusions Fluid accumulation is an important risk factor for lengthening mechanical ventilation, particularly in patients on hemodialysis. Future studies are warranted to address the ideal timing for initiating dialysis in this scenario in an attempt to reduce fluid accumulation and avoid prolonged ventilation time and hospital stay.

Background Fluid overload is a risk factor for morbidity, mortality, and prolonged ventilation time after surgery. Patients on maintenance hemodialysis might be at higher risk. We hypothesized that fluid accumulation would be directly associated with extended ventilation time in patients on hemodialysis, as compared to patients with chronic kidney disease not on dialysis (CKD3-4) and patients with normal renal function (reference group).Methods this is a prospective observational study that included consecutive patients submitted to an isolated and elective coronary artery bypass surgery classified as reference (N=167, normal renal function), CKD3-4 (N=84, estimated glomerular filtration rate 30-60ml/min/1.73m 2 ), and hemodialysis (N=31, maintenance hemodialysis) groups. The same observer followed patients daily from the surgery to the hospital discharge.Results Fluid accumulation correlated with time on mechanical ventilation in patients on hemodialysis (r=0.627, p=0.003), but not in the CKD3-4 group (r=-0.068, p=0.652) and in the reference group (r=-0.085, p=0.363). Multivariate analysis revealed that the fluid accumulation, scores of sequential organ failure assessment-SOFA in the day following surgery, and the group according to renal function were independently associated with ventilation time. Furthermore, in patients on hemodialysis, the time between surgery and the first hemodialysis also accounted for the time on mechanical ventilation.Conclusions Fluid accumulation is an important risk factor for lengthening mechanical ventilation, particularly in patients on hemodialysis. Future studies are warranted to address the ideal timing for initiating dialysis in this scenario in an attempt to reduce fluid accumulation and avoid prolonged ventilation time and hospital stay.