Objective: To characterize the epidemiological profile of the hospitalized population in the ICU of Hospital das Clínicas de Marília (Famema). Method: A retrospective, descriptive and quantitative study. Data regarding patients admitted to the ICU Famema was obtained from the Technical Information Center (Núcleo Técnico de Informações, NTI, Famema). For data analysis, we used the distribution of absolute and relative frequencies with simple statistical treatment. Results: 2,022 ICU admissions were recorded from June 2010 to July 2012 with 1,936 being coded according to the ICD-10. The epidemiological profile comprised mostly males (57.91%), predominantly seniors ≥ 60 years (48.89%), at an average age of 56.64 years (±19.18), with limited formal education (63.3% complete primary school), mostly white (77.10%), Catholic (75.12%), from the city of Marília, state of São Paulo, Brazil (53.81%). The average occupancy rate was 94.42%. The predominant cause of morbidity was diseases of the circulatory system with 494 admissions (25.5%), followed by traumas and external causes with 446 admissions (23.03%) and neoplasms with 213 admissions (11.00%). The average stay was 8.09 days (±10.73). The longest average stay was due to skin and subcutaneous tissue diseases, with average stay of 12.77 days (±17.07). There were 471 deaths (24.32%), mainly caused by diseases of the circulatory system (30.99%). The age group with the highest mortality was the range from 70 to 79 years with 102 deaths (21.65%). Conclusion:The ICU Famema presents an epidemiological profile similar to other intensive care units in Brazil and worldwide, despite the few studies available in the literature. Thus, we feel in tune with the treatment of critical care patients.

Introduction: Prognostic factors are used in the Intensive Care Unit (ICU) to predict morbidity and mortality, especially in patients on mechanical ventilation (MV). Training protocols are used in MV patients with the aim of promoting the success of the weaning process. Objective: To assess which variables determine the outcome of patients undergoing mechanical ventilation and compare the effects of two protocols for weaning. Method: Patients under MV for more than 48 hours had collected the following information: gender, age, ideal weight, height, Acute Physiology and Chronic Health Evaluation (APACHE II), risk of mortality, Glasgow Coma Scale (GCS) and index Quick and perfunctory (IRRS) breathing. Patients with unsuccessful weaning performed one of weaning protocols: Progressive T -tube or tube -T + Threshold ® IMT. Patients were compared for outcome (death or non-death in the ICU) and the protocols through the t test or Mann-Whitney test was considered significant when P <0.05. Results: Of 128 patients evaluated 56.25% were men, the mean age was 60.05 ± 17.85 years and 40.62% patients died, and they had higher APACHE II scores, mortality risk, time VM and IRRS GCS and the lower value (p<0.05). The age, initial and final maximal inspiratory pressure, time of weaning and duration of MV was similar between protocols. Conclusion: The study suggests that the GCS, APACHE II risk of mortality, length of MV and IRRS variables determined the evolution of MV patients in this sample. Not found differences in the variables studied when comparing the two methods of weaning. Keywords: Intensive Care Unit; Mortality; Ventilator weaning; Respiration, artificial; APACHE; Airway extubation. ResumoIntrodução: Fatores prognósticos são usados na Unidade de Terapia Intensiva (UTI) para predizer morbimortalidade, especialmente em pacientes em Ventilação Mecânica (VM). Protocolos de treinamento são utilizados em pacientes em VM com o intuito de promover o sucesso no processo de desmame ventilatório. Objetivo: Avaliar quais variáveis determinam a evolução de pacientes submetidos à ventilação mecânica e comparar os efeitos de dois protocolos de desmame ventilatório. Método: Pacientes em VM por mais de 48h tiveram as seguintes informações coletadas: sexo, idade, massa ideal, estatura, Acute Physiology and Chronic Health Evaluation (APACHE II), risco de mortalidade, Escala de Coma de Glasgow (ECGl) e Índice de Respiração Rápida e Superficial (IRRS). Pacientes com insucesso de desmame realizaram um dos protocolos de desmame: Tubo-T progressivo ou Tubo-T + Threshold ® IMT. Os pacientes foram comparados quanto ao desfecho (óbito ou não-óbito na UTI) e quanto aos protocolos por meio do Teste t ou Teste Mann-Whitney, foi considerado como significante p<0.05. Resultados: Dos 128 pacientes avaliados 56,25% eram homens, a idade média era 60,05±17,85 anos e 40,62% pacientes foram a óbito, sendo que estes apresentaram maiores valores de APACHE II, risco de mortalidade, tempo de VM e IRRS e menor valor de ECGl (p<0,05). A idade, pressão in...

Thromboprophylaxis is underused in this population, and an inappropriate dose was prescribed in 50% of cases. Therefore, future studies and interventions should include an educational program started from the emergency department care, an essential step to bring evidence closer to clinical practice.

Introduction: Identification of predictors for successful extubation in an Intensive Care Unity and use of Brain Natriuretic Peptides (BNP) in predicting mechanical ventilation weaning and extubation outcome.Aims: Evaluation of the effect of variables such as patient´s age, severity score, use of sedation, use of vasoactive drugs, hydric balance, blood gas data, days under mechanical ventilation, the occurrence of adverse events and plasma BNP levels on the success of extubation.Method: A prospective cohort study of adult patients admitted to a 12- bed-general ICU, from April 1st 2016 to August 10th 2017, under mechanical ventilation for > 24 h, accompanied until discharge or death. Clinical variables were analyzed and BNP was assessed before initiation of Spontaneous Breathing Trial (SBT) and then again before extubation. Statistical Analysis: a descriptive and comparative data analysis, univariate and logistic regressionanalysis for verification of variables independently related to successful extubation (p < 0.05).Results: Study of 105 patients, mean age of 53.9 ± 19.8 years, 81% of success in extubation; the overall mortality rate of 11.4%; variables associated to successful extubation: age, APACHE II, SAPS II, days of hospitalization before ICU admittance, days under mechanical ventilation, days of stay in ICU and occurrence of nosocomial infection (p < 0.05); BNP levels were lower in patients with successful extubation although not statistically significant;multivariate analysis showed that patient’s age and days of hospitalization before ICU admittance were each independently linked to extubation failure; APACHE II score and days of hospitalization before ICU admittance were each independently associated to risk of death.Conclusion: Despite being older and with higher severity scores, patients had a higher success rate in extubation than found in similar studies. However, the mortality rate in cases of failed extubation was higher. Data obtained was in agreement to studies that suggested that patient´s age, severity score, days of hospitalization before ICU admittance, days of stay in ICU, days under MV and infection occurrence were all variables associated as much extubation failure as to risk of death. A direct association between BNP levels and successful extubation and the usefulness of assessing BNP in the conduction of WMV was not confirmed.

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