Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 1.257
Filter
1.
Belo Horizonte; UFMG/EEFFTO; 1; 20240000. 17 p. ilus.
Non-conventional in Portuguese | LILACS, BDENF, ColecionaSUS | ID: biblio-1579684

ABSTRACT

O empilhamento de ar é uma técnica realizada com um "AMBU" que vai te permitir encher todo o pulmão de ar. Essa técnica é muito utilizada por pessoas que não conseguem respirar de forma adequada.


Subject(s)
Humans , Respiration, Artificial/instrumentation , Insufflation , Peak Expiratory Flow Rate , Vital Capacity , Practice Guideline , Cough , Amyotrophic Lateral Sclerosis
2.
Rev. colomb. anestesiol ; 52(3): 3, July-Sept. 2024. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1576176

ABSTRACT

Abstract Introduction: Factors associated with mortality among mechanically ventilated COVID-19 patients have been scarcely studied in Latin America. Objective: To identify factors associated with mortality in mechanically ventilated COVID-19 patients. Methods: This prospective study was undertaken in a single center between April and October 2020, recruiting COVID-19 patients managed with mechanical ventilation. We excluded patients who died within the first 24 hours after endotracheal intubation. Clinical characteristics, laboratory results, ventilation interventions, and outcomes were collected and compared between the deceased and surviving groups. The association between these factors and hospital death was examined, and relevant covariates were included in a multivariate logistic regression model. Results: A total of 273 patients were included (72.5% male), the mortality rate was 37% (95% CI 31% - 43%), and the median age was 63 years (IQR 52-72). The most frequent comorbidity was hypertension (45%). Factors associated with mortality were: older age (OR 1.08; 95% CI 1.051.11), male gender (OR 2.79; 95% CI 1.30-6.01), immunosuppression (OR 3.98; 95% CI 1.57-10.06), thrombocytopenia (OR 3.84; CI 95% 1.47-10.01), driving pressure (OR 1.20; 95% CI 1.07-1.34) and the use of dialysis (OR 4.94; 95% CI 2.56-9.51). Chronic hypertension (OR 0.35; 95% CI 0.17-0.71) and fever on admission (OR 0.51; 95% CI 0.27-0.98) were found to have a protective effect. Conclusions: Older age, male sex, immunosuppression, thrombocytopenia, increased driving pressure, use of dialysis, absence of fever, or arterial hypertension were associated with an increased risk of mortality among mechanically ventilated COVID-19 patients.


Resumen Introducción: Es poco lo que se han estudiado en América Latina los factores asociados con mortalidad en pacientes con COVID-19 ventilados mecánicamente. Objetivo: Identificar los factores asociados con mortalidad en pacientes con COVID-19 manejados con ventilación mecánica. Métodos: Este estudio prospectivo se adelantó en un solo centro entre los meses de abril y octubre de 2020 e incluyó pacientes con COVID-19 manejados con ventilación mecánica. Se excluyeron pacientes que fallecieron en las primeras 24 horas después de la intubación orotraqueal. Se recopilaron datos de las características clínicas, resultados de laboratorio, intervenciones ventilatorias y desenlaces, y se hizo una comparación entre el grupo de pacientes fallecidos y el grupo de sobrevivientes. Se examinó la asociación entre estos factores y la muerte intrahospitalaria, y las covariables relevantes se incluyeron en un modelo multivariable de regresión logística. Resultados: Se incluyó un total de 273 pacientes (72.5% hombres), la tasa de mortalidad fue del 37% (IC 95% 31% - 43%), la mediana de edad fue de 36 años (RIC 52-72) y la comorbilidad más frecuente fue la hipertensión (45%). Los factores asociados con mortalidad fueron: edad avanzada (OR 1.08; IC 95% 1.05-1.11), género masculino (OR 2.79; IC 95% 1.30-6.01), inmunosupresión (OR 3.98; IC 95% 1.57-10.06), trombocitopenia (OR 3.84; CI 95% 1.47-10.01), presión de distensión (OR 1.20; IC 95% 1.07-1.34) y el uso de diálisis (OR 4.94; IC 95% 2.56-9.51). La presencia de hipertensión (OR 0.35; IC 95% 0.17-0.71) y de fiebre (OR 0.51; IC 95% 0.27-0.98) al momento de la hospitalización demostraron tener un efecto protector. Conclusiones: Se encontró asociación entre la edad avanzada, el sexo masculino, la inmunosupresión, la trombocitopenia, una presión de distensión elevada, el uso de diálisis, la ausencia de fiebre o de hipertensión y un mayor riesgo de mortalidad en pacientes con COVID-19 ventilados mecánicamente.

3.
Int. j interdiscip. dent. (Print) ; 17(2): 102-104, ago. 2024. ilus
Article in Spanish | LILACS | ID: biblio-1569230

ABSTRACT

Se describe el caso clínico de una paciente de 8 años de edad, sexo femenino que presenta respiración oral, anomalía dentomaxilar, interposición lingual en deglución, fonación, lengua descendida en reposo y adaptaciones musculoesqueléticas por lo que requiere tratamiento de Ortodoncia, Fonoaudiología y Kinesiología. El presente reporte de caso describe la interacción de las especialidades requeridas para el manejo adecuado de la paciente y expone un flujograma sugerido para abordar casos similares.


The following is a clinical case of an eight-year-old female patient who presents oral respiration, dentomaxilar anomaly, tongue interposition during swallowing and phonation, lowered tongue at rest and musculoskeletal adaptations, hence requires orthodontics, speech and physical therapy. This case report describes the interaction of the specialties necessary for the proper management of the patient and presents a suggested flow chart to address similar cases.


Subject(s)
Humans , Female , Child , Tooth Abnormalities/etiology , Mouth Breathing/complications , Mouth Breathing/rehabilitation , Patient Care Team , Phonation , Speech Therapy , Physical Therapy Modalities
4.
Horiz. sanitario (en linea) ; 23(2): 323-330, may.-ago. 2024. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1582422

ABSTRACT

Resumen Objetivo: Identificar los factores asociados al tipo de respiración artificial y al fallecimiento de pacientes hospitalizados causada por Sars-Cov2 en un hospital de tercer nivel de Mérida, Yucatán de enero a agosto de 2022. Material y métodos: Estudio observacional retrospectivo. La recolección de datos se realizó en mayo y junio de 2023 en el Hospital Elvia Carrillo Puerto del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) en Mérida, Yucatán. La muestra incluyó 100 expedientes a partir de 133 de pacientes que recibieron algún tipo de respiración artificial VMNI (ventilación mecánica no invasiva) o VMI (ventilación mecánica invasiva) por parte de la unidad de inhaloterapia, diagnosticados con COVID-19 y estuvieron hospitalizados de enero a agosto de 2022. Los datos fueron recabados a través de una cédula y fueron procesados a través de estadística descriptiva, análisis bivariado y multivariado: regresión logística binaria (IC= 95 %). Resultados: De los 100 expedientes incluidos en el estudio: 40 recibieron VMNI y 60 VMI, el 56 % correspondió a personas de sexo hombre, 91 % residente en Yucatán y 85% nacido en esta misma entidad federativa. Diabetes tipo 2 e hipertensión arterial estuvieron asociadas a fallecimiento a la VMI. Del total de expedientes de pacientes incluido en la muestra de estudio: 37 recibieron el alta domiciliaria mientras que 63 fallecieron en el hospital. El número de días con ventilación mecánica, el promedio fue superior en aquellos que fallecieron y significativamente menor en aquellos que recibieron el alta domiciliario. En el análisis de regresión, el sobrepeso y mayor edad fueron variables predictoras de fallecimiento para los pacientes, mientras que haber recibido VMNI resultó un factor protector. Conclusión: El sobrepeso y la edad fueron factores predictores para fallecer por COVID-19 en este estudio, mientras que haber recibido VMNI fue un factor protector; la VMNI resultó un factor protector ante el fallecimiento y asociado a supervivencia hospitalaria.


Abstract Objective: Identify the factors associated with the type of artificial respiration and the death of hospitalized patients caused by Sars-Cov2 in a tertiary hospital in Mérida, Yucatán from January to August 2022. Material and methods: Retrospective observational study. Data collection was carried out in May and June 2023 at the Elvia Carrillo Puerto Hospital of the Institute of Security and Social Services of State Workers (ISSSTE) in Mérida, Yucatán. The sample included 100 records from 133 patients who received some type of artificial respiration NIV (non-invasive mechanical ventilation) or IMV (invasive mechanical ventilation) by the inhalation therapy unit, diagnosed with COVID-19 and were hospitalized from January to August 2022. Data were collected through a card and were processed through descriptive statistics, bivariate and multivariate analysis: binary logistic regression (CI= 95%). Results: Of the 100 files included in the study: 40 received NIV and 60 IMV, 56% corresponded to men, 91% were residents in Yucatán, and 85% were born in this same state. Type 2 diabetes and high blood pressure were associated with death due to IMV. Of the total patient records included in the study sample: 37 were discharged home while 63 died in the hospital. The average number of days with mechanical ventilation was higher in those who died and significantly lower in those who were discharged home. In the regression analysis, overweight and older age were predictor variables of death for patients, while having received NIV was a protective factor. Conclusion: Overweight and age were predictive factors for dying from COVID-19 in this study, while the absence of IMV was a protective factor; NIV was a protective factor against death and associated with hospital survival.

6.
J Biosci ; 2024 Mar; 49: 1-6
Article | IMSEAR | ID: sea-237965

ABSTRACT

Phototrophic organisms harbor two main bioenergetic hubs, photosynthesis and respiration, and these processes dynamically exchange and share metabolites to balance the energy of the cell. In microalgae and cyanobacteria, the crosstalk between the light-triggered reactions of photosynthesis and respiration is particularly prominent with respiratory O2 uptake which can be stimulated upon illumination. Since its discovery, this light-enhanced respiration has been proposed to be critical in dissipating the excess reducing power generated by photosynthesis. Importantly, the physiological role and putative molecular mechanism involved have just recently started to be understood. Here, we revisit the physiological functions and discuss possible molecular mechanisms of interactions between the photosynthetic and respiratory electron flows in microalgae and cyanobacteria.

7.
Argentinian j. respiratory physical therapy ; 6(1): 12-19, ene. 2024. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1573903

ABSTRACT

RESUMEN Objetivo: El objetivo de este estudio es determinar si existe asociación entre el impulso respiratorio, evaluado a través de la presión de oclusión (P0.1), y la profundidad de sedación, medida a través de la escala de agitación-sedación de Richmond (RASS, por sus siglas en inglés), en sujetos adultos sometidos a ventilación mecánica invasiva e internados en la unidad de cuidados intensivos del Hospital de Clínicas José de San Martín (HCJSM) en Buenos Aires. Como objetivo secundario, se planteó analizar el comportamiento de variables que pudieran tener impacto en el impulso respiratorio. Materiales y método: Se realizó un estudio observacional en un hospital universitario de la Ciudad Autónoma de Buenos Aires entre el 1 de abril de 2023 y el 28 de mayo de 2023. Las variables analizadas fueron P0.1, RASS, dolor, delirio, exposición a analgésicos y sedantes, estado ácido-base, presión arterial de oxígeno/fracción inspirada de oxígeno (PaO2/FiO2), evaluación de falla orgánica relacionada con la sepsis (SOFA, por sus siglas en inglés) e índice de masa corporal (IMC). Resultados: Se recolectaron 71 mediciones correspondientes a 33 sujetos. La mediana de P0.1 fue de 0,13 cmH20 (0-0,97). En el análisis univariado, se encontró una asociación inversamente proporcional entre la P0.1 y el puntaje RASS (β=-0,4068 y p=0,0435). Los resultados del análisis multivariado mostraron que ninguna de las variables contempladas se asoció con la P0.1 cuando fueron ajustadas entre sí. Conclusión: En este estudio, encontramos una asociación entre la P0.1 y el puntaje RASS, así como una asociación independiente entre la P0.1 y la exposición a la combinación de analgesia y sedación. Sin embargo, al ajustar estas variables en el análisis multivariado, no se encontró asociación.


ABSTRACT Objective: The objective of this study is to determine whether there is an association between respiratory drive, assessed through P0.1, and depth of sedation, measured through the Richmond agitation-sedation scale (RASS), in adult subjects undergoing invasive mechanical ventilation and admitted to the intensive care unit of Hospital de Clínicas José de San Martín (HCJSM) in Buenos Aires. As a secondary objective, we aim to analyze the behavior of variables that may have an impact on respiratory drive. Materials and method: An observational study was conducted at a university hospital in the Autonomous City of Buenos Aires between April 1, 2023, and May 28, 2023. The analyzed variables included P0.1, RASS, pain, delirium, exposure to analgesics and sedatives, acid-base status, pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2), sepsis-related organ failure assessment (SOFA), and body mass index (BMI). Results: A total of 71 measurements were collected from 33 subjects. The median P0.1 was 0.13 cmH20 (0-0.97). In the univariate analysis, an inversely proportional association was found between P0.1 and RASS score (β=-0.4068 and p=0.0435). The results of the multivariate analysis showed no association between P0.1 and any of the considered variables when adjusted for each other. Conclusion: In this study, we found an association between P0.1 and RASS score, along with an independent association between P0.1 and exposure to the combination of analgesia and sedation. However, when adjusting these variables in the multivariate analysis, no association was found.

8.
Article in Chinese | WPRIM | ID: wpr-1028519

ABSTRACT

Objective:To evaluate the effect of individualized positive end-expiratory pressure (PEEP) titration based on open-lung strategy on the intraoperative thoracic fluid content (TFC) in elderly patients undergoing transurethral ultrasound-guided laser-induced prostatectomy (TULIP).Methods:Eighty-six American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, patients, aged 65-80 yr, with body mass index of 18-28 kg/m 2, scheduled for elective TULIP, were divided into 2 groups ( n=43 each) by the random number table method: fixed PEEP group (group C) and individualized PEEP titration group (group P). PEEP was set at 4 cmH 2O after routine mechanical ventilation in group C. Patients underwent pulmonary recruitment maneuvers combined with individualized PEEP titration during surgery in group P. TFC was measured using a non-invasive cardiac output monitor at 5 min after tracheal intubation (T 0), 30 min after PEEP titration and ventilation (T 1), 5 min before surgery (T 2), and 5 min before leaving the recovery room (T 3). Cardiac output, oxygenation index and stroke volume index were recorded from T 0-T 2, arterial blood gas analysis was simultaneously performed to record peak airway pressure and dynamic lung compliance, and oxygenation index was calculated. The duration of postanesthesia care unit stay, pulmonary complications within 7 days after surgery, and length of hospital stay were also recorded. Results:Eighty-three patients were finally included, with 42 in group C and 41 in group P. Compared with group C, TFC was significantly decreased at T 1-T 3, cardiac index, cardiac output and stroke volume index were decreased at T 1, dynamic lung compliance, PaO 2 and oxygenation index were increased at T 1 and T 2, PaCO 2 was decreased, the incidence of postoperative pulmonary complications was reduced, and the duration of postanesthesia care unit stay and postoperative length of hospital stay were shortened in group P ( P<0.05). Conclusions:Individualized PEEP titration based on open-lung strategy can effectively decrease TFC and improve intraoperative oxygenation and prognosis in elderly patients undergoing TULIP.

9.
Article in Chinese | WPRIM | ID: wpr-1028521

ABSTRACT

Objective:To evaluate the effect of lung recruitment maneuvers combined with individualized positive end-expiratory pressure(PEEP) on the degree of postoperative atelectasis in elderly patients undergoing laparoscopic surgery.Methods:One hundred and forty-three elderly patients, aged ≥65 yr, with body mass index of 18.5-30.0 kg/m 2, scheduled for elective laparoscopic surgery, were assigned to either individualized PEEP combined with recruitment maneuvers (group Ⅱ) or fixed PEEP (group Ⅰ) using a random number table method. PEEP was maintained at 6 cmH 2O starting from the beginning of procedure until the end of the procedure in group I. Individualized PEEP titration was performed after induction of anesthesia in group Ⅱ. The primary outcome measure was the 12-zone lung ultrasound score at 15 min after tracheal extubation. Other outcome measures were the occurrence of postoperative pulmonary complications within 7 days after surgery, Quality of Recovery-15 scale score on 3rd day after surgery, rate of unplanned admission to intensive care units, length of hospital stay, incidence of intraoperative hypoxemia, usage rate of intraoperative vasoactive drugs, and incidence of postoperative hypotension. Results:Compared with group Ⅰ, the lung ultrasound score, driving pressure and postoperative pulmonary complications were significantly decreased, the dynamic lung compliance was increased ( P<0.05 or 0.01), and no significant changes were found in the other parameters in group Ⅱ ( P>0.05). Conclusions:Individualized PEEP combined with recruitment maneuvers can reduce the degree of postoperative atelectasis in elderly patients undergoing laparoscopic surgery.

10.
Article in Chinese | WPRIM | ID: wpr-1020443

ABSTRACT

Objective:To establish an environmental management strategy for the prevention of ventilator-associated pneumonia from the perspective of etiological characteristics and to verify its application effect.Methods:Based on a sampling survey, this study constructed preventive management strategies for ventilator-associated pneumonia by blocking pathogen characteristics from the perspective of both colonization and infection management in patients. From July 2021 to June 2023, a non-synchronous randomized controlled study was conducted, including a control group of 59 cases and an experimental group of 57 cases from ICU of Tianjin Teda Hospital, all of them were mechanically ventilated patients. The effectiveness of the strategy was confirmed.Results:In the control group, there were 35 males and 24 females, with an average age of (46.97 ± 18.84) years. In the experimental group, there were 39 males and 18 females, with an average age of (47.49 ± 13.85) years. During the study period, there were 9 cases of ventilator-associated pneumonia (VAP) in the control group and 2 cases in the experimental group, the difference between the two groups was statistically significant (exact odds ratio=0.031). The duration of mechanical ventilation in the experimental group (122.41 ± 18.36) h, which was shorter than that in the control group (187.62 ± 18.05) h, and the difference was statistically significant ( t=19.28, P<0.05). The length of ICU stay in the experimental group was (8.38 ± 0.79) d, in the control group was (10.99 ± 1.10) d, the difference between them was statistically significant ( t=14.66, P<0.05). On the 7th day, there were 7 cases of positive pathogenic bacteria in sputum culture in the experimental group, which was significantly different from the 29 cases in the control group ( χ2=16.73, P<0.05). Conclusions:The vector management strategy for preventing ventilator-associated pneumonia by blocking etiological characteristics can reduce the incidence of VAP, shorten the duration of mechanical ventilation and ICU stay, and reduce the pathogen load in the sputum of mechanically ventilated patients on the 7th day.

11.
Article in Chinese | WPRIM | ID: wpr-1020446

ABSTRACT

Objective:To explore the factors leading to communication disorders in ICU patients during mechanical ventilation from the perspective of both patients and medical staff, and to use the theoretical framework of acceptability to identify the barriers that can be improved by intervention.Methods:Using the method of descriptive phenomenology from July to August 2022, 11 patients with mechanical ventilation and 8 medical staff in the comprehensive ICU of a Yuhuangding Hospital in Yantai were selected for interviews by the purpose sampling method, combined with participatory observation. The interviews of patients were conducted off ventilator. With Nvivo12.0 Plus software, the seven-step analysis method of Colaizzi phenomenology was adopted to summarize the theme and the theoretical framework of acceptability was used to identify the obstacle factors that could be improved by intervention.Results:The age of 11 patients was 18-46 years old, the duration of mechanical ventilation was 9.5-312.3 h. The age of 8 medical staff was 26-54 years old, the length of service in ICU was 2-30 years. A total of 14 themes were extracted. For patients: defensive mood, difficulty in presenting information, introverted personality, communication tools are hard to use, emergency treatment conflict, deny the ability to communicate, thought slowness. For medical staff: defensive mood, cognitive load, high time cost, lack of humane communication strategies, poor training, other priorities, loss of confidence in effective communication, awareness of the importance of communication was not enough.Conclusions:There are many factors that can be improved for patients with mechanical ventilation in ICU. It is suggested to speed up the research and development of high-tech and personalized alternative communication tools in China, reduce negative communication between doctors and patients and nurses and patients, and implement evidence-based multi-mode and progressive communication intervention strategies.

12.
Tianjin Medical Journal ; (12): 188-193, 2024.
Article in Chinese | WPRIM | ID: wpr-1020994

ABSTRACT

Objective To explore the effect of individualized positive end expiratory pressure guided by driving pressure on lung protection after laparoscopic radical gastrectomy for elderly patients.Methods A total of 64 patients underwent elective laparoscopic radical gastrectomy for gastric cancer in the Second Affiliated Hospital of Anhui Medical University were selected.According to the random number table method,patients were divided into the driving the pressure guided individualized positive end-expiratory pressure(PEEP)group(experimental group)and the fixed PEEP group(control group),32 cases in each group.In the control group,PEEP = 5 cmH2O.In the experimental group,PEEP titration was performed according to the increasing method,and the PEEP corresponding to the lowest driving pressure was selected until extubation.Peak airway pressure(Ppeak),plateau airway pressure(Pplat)and PEEP were recorded at 5 min after intubation(T1),immediately after PEEP titration(T2),1 h after operation(T3),2 h after operation(T4),and 10 min after pneumoperitoneum release(T5).Driving pressure(ΔP)and lung dynamic compliance(Cdyn)were calculated.Arterial blood was collected at T1-5 for blood gas analysis,arterial partial pressure of oxygen(PaO2)was recorded,and oxygenation index(OI)was calculated.The occurrence of pulmonary complications(PPCs)within 7 days after operation was recorded.Modified clinical pulmonary infection score(mCPIS)was recorded on the second day after operation.The pulmonary function was evaluated before operation,1 day,3 days and 5 days after operation.Results Compared with T1,Ppeak,Pplat and ΔP were increased and Cdyn was decreased at T2-5,while OI was decreased at T4 in control group(P<0.05).Compared with the control group,Ppeak,Pplat and Cdyn in the experimental group were increased at T2-5,ΔP was decreased,and OI was increased at T3-5(P<0.05).Compared with the preoperative results,FVC at 1,3 and 5 days after surgery was decreased,and FEV1 and maximum expiratory flow(PEF)were decreased 1 and 3 days after surgery in the experimental groups(P<0.05).Compared with the control group,FVC,FEV1 and PEF were higher 1 day after operation in the experimental group(P<0.05).Compared with the preoperative results,mCPIS scores of the two groups were higher on the second day after surgery(P<0.05).Compared with the control group,the mCPIS score was lower on day 2 after surgery in the experimental group(P<0.05).The incidence of PPCs within 7 days after surgery was lower in the experimental group than that in the control group(15.6%vs.40.6%).Conclusion Individualized PEEP guided by drive pressure can improve lung compliance,reduce drive pressure,improve oxygenation function and early postoperative lung function,reduce the incidence of postoperative lung complications,and has a certain lung protection effect.

13.
Tianjin Medical Journal ; (12): 324-326, 2024.
Article in Chinese | WPRIM | ID: wpr-1021019

ABSTRACT

Recognizing upper airway obstruction and stenosis is critical to determine the subsequent treatment options in patients with obstructive sleep apnea(OSA).Drug-induced sleep endoscopy(DISE)is a 3D visual evaluation technology for the anatomical structure of the upper respiratory tract of OSA patients during"sleeping"state after being anesthetized.The dynamic situation of upper respiratory tract obstruction and collapse can be observed safely and quickly through endoscopy,which provides important reference for formulating surgical methods and positive airway pressure(PAP)intervention treatments.With the assistance of polysomnography(PSG),DISE plays an important role in optimizing individualized treatment plans for OSA.The present article introduces the technical operating points of PSG-assisted drug-induced sleep endoscopic positive airway pressure titration.

14.
São Paulo med. j ; São Paulo Med. J. (Online);142(1): e2022470, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1450506

ABSTRACT

ABSTRACT BACKGROUND: Respiratory failure is the most common cause of death in patients with amyotrophic lateral sclerosis (ALS), and morbidity is related to poor quality of life (QOL). Non-invasive ventilation (NIV) may be associated with prolonged survival and QOL in patients with ALS. OBJECTIVES: To assess whether NIV is effective and safe for patients with ALS in terms of survival and QOL, alerting the health system. DESIGN AND SETTING: Systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting standards using population, intervention, comparison, and outcome strategies. METHODS: The Cochrane Library, CENTRAL, MEDLINE, LILACS, EMBASE, and CRD databases were searched based on the eligibility criteria for all types of studies on NIV use in patients with ALS published up to January 2022. Data were extracted from the included studies, and the findings were presented using a narrative synthesis. RESULTS: Of the 120 papers identified, only 14 were related to systematic reviews. After thorough reading, only one meta-analysis was considered eligible. In the second stage, 248 studies were included; however, only one systematic review was included. The results demonstrated that NIV provided relief from the symptoms of chronic hypoventilation, increased survival, and improved QOL compared to standard care. These results varied according to clinical phenotype. CONCLUSIONS: NIV in patients with ALS improves the outcome and can delay the indication for tracheostomy, reducing expenditure on hospitalization and occupancy of intensive care unit beds. SYSTEMATIC REVIEW REGISTRATION: PROSPERO database: CRD42021279910 — https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=279910.

15.
CoDAS ; 36(2): e20220339, 2024. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1528452

ABSTRACT

RESUMO Há diversas abordagens que podem ser utilizadas para atingir os objetivos terapêuticos nos distúrbios relacionados às funções de mastigação, deglutição, fala e respiração. Entretanto, a literatura necessita de evidências que fundamentem o uso na prática clínica fonoaudiológica. O objetivo desta revisão foi mapear as sínteses de evidências sobre intervenção fonoaudiológica nas áreas de respiração, mastigação, deglutição e fala em adultos e idosos.‬ Foram incluídos apenas estudos classificados por seus autores como revisão sistemática, que abordaram terapia para disfunções orofaciais em indivíduos maiores de 18 anos. Os procedimentos realizados foram: busca eletrônica e manual; seleção dos estudos; extração dos dados; avaliação da qualidade dos estudos e análise de dados. Foi possível observar diversos tipos de intervenções principalmente voltadas à função de deglutição, abarcando desde a terapia tradicional até a utilização de dispositivos. Contudo, devido às limitações dos estudos, os dados devem ser interpretados com cautela.


ABSTRACT There are several types of approaches that can be used to achieve therapeutic goals in disorders related to the functions of mastication, swallowing, speech, and breathing. However, the literature lacks evidence to support their use in speech-language clinical practice. The objective of this review was to map the syntheses of evidence on speech-language pathology intervention in the areas of breathing, mastication, swallowing and speech in adults and the elderly. Only studies classified by their authors as a systematic review, studies that addressed therapy for orofacial disorders in individuals over 18 years of age were included. The procedures performed included: electronic and manual search; selection of studies; data extraction; evaluation of the quality of studies and data analysis. It was possible to observe different types of interventions mainly aimed at the swallowing function, ranging from traditional therapy to the use of devices. However, due to the limitations of the studies, the data must be interpreted with caution.

16.
Acta Paul. Enferm. (Online) ; 37: eAPE02751, 2024. tab
Article in Portuguese | LILACS-Express | LILACS, BDENF | ID: biblio-1519810

ABSTRACT

Resumo Objetivo Descrever a prevalência de lesão renal aguda em adultos jovens com diagnóstico da COVID-19 admitidos em unidade terapia intensiva. Métodos Estudo retrospectivo, quantitativo e analítico. A amostra foi de adultos jovens (20 a 40 anos) admitidos em unidades de terapia intensiva, com diagnóstico de infecção por SARS-CoV-2 entre março e dezembro de 2020. Os dados foram obtidos por meio do prontuário eletrônico, e a lesão renal aguda foi definida pelo valor da creatinina, segundo critérios das diretrizes da Kidney Disease Improving Global Outcomes. A significância estatística foi de p≤0,05. Resultados Foram internados 58 adultos jovens, sendo 63,8% do sexo masculino. A hipertensão arterial sistêmica esteve presente em 39,6%, a obesidade em 18,9% e o diabetes mellitus em 8,6%. A lesão renal aguda foi identificada em 55,1%, sendo o estágio 3 predominante em 43,1% deles. Nesses pacientes, o uso de ventilação mecânica e de drogas vasoativas foi significativo em 92%, assim como a disfunção orgânica respiratória (80%), seguida da renal (76%). Fatores de risco, como transplante renal ou doença renal crônica e obesidade, aumentaram em 12,3 e 9,0 vezes, respectivamente, a chance de desenvolver lesão renal aguda. Conclusão Este estudo demonstrou alta prevalência de lesão renal em adultos jovens e sua associação com comorbidades prévias. Obesidade, transplante renal e doença renal crônica elevaram a chance de o adulto jovem desenvolver lesão renal aguda, resultando em desfechos a favor da morbimortalidade.


Resumen Objetivo Describir la prevalencia de lesión renal aguda en adultos jóvenes con diagnóstico de COVID-19 admitidos en unidad de cuidados intensivos. Métodos Estudio retrospectivo, cuantitativo y analítico. La muestra fue de adultos jóvenes (20 a 40 años) admitidos en unidades de cuidados intensivos, con diagnóstico de infección por SARS-CoV-2 entre marzo y diciembre de 2020. Los datos se obtuvieron por medio de historias clínicas electrónicas, y la lesión renal aguda fue definida por el valor de la creatinina, de acuerdo con criterios de las directrices de la Kidney Disease Improving Global Outcomes. La significación estadística fue de p≤0,05. Resultados Hubo 58 adultos jóvenes internados, el 63,8 % de sexo masculino. La hipertensión arterial sistémica estuvo presente en el 39,6 %, la obesidad en el 18,9 % y la diabetes mellitus en el 8,6 %. Se identificó lesión renal aguda en el 55,1 %, de nivel 3 como predominante en el 43,1 % de los casos. En esos pacientes, el uso de ventilación mecánica y de drogas vasoactivas fue significativo en el 92 %, así como también la disfunción orgánica respiratoria (80 %), seguida de la renal (76 %). Los factores de riesgo, como trasplante renal o enfermedad renal crónica y obesidad, aumentaron 12,3 y 9,0 veces respectivamente la probabilidad de presentar lesión renal aguda. Conclusión Este estudio demostró alta prevalencia de lesión renal en adultos jóvenes y su asociación con comorbilidades previas. La obesidad, el trasplante renal y la enfermedad renal crónica aumentaron la probabilidad de que los adultos jóvenes presenten lesión renal aguda, lo que da como resultado desenlaces a favor de la morbimortalidad.


Abstract Objective To describe acute kidney injury prevalence in young adults diagnosed with COVID-19 admitted to the Intensive Care Unit. Methods This is a retrospective, quantitative and analytical study. The sample consisted of young adults (20 to 40 years old) admitted to Intensive Care Units, diagnosed with SARS-CoV-2 infection between March and December 2020. Data were obtained through electronic medical records, and kidney injury acute was defined by the creatinine value, according to the Kidney Disease Improving Global Outcomes guidelines criteria. Statistical significance was p≤0.05. Results A total of 58 young adults were hospitalized, 63.8% of whom were male. Hypertension was present in 39.6%, obesity in 18.9%, and diabetes mellitus in 8.6%. Acute kidney injury was identified in 55.1%, with stage 3 predominating in 43.1% of them. In these patients, the use of mechanical ventilation and vasoactive drugs was significant in 92% as well as respiratory organ dysfunction (80%), followed by renal organ dysfunction (76%). Risk factors such as kidney transplantation or chronic kidney disease and obesity increased by 12.3 and 9.0 times, respectively, the chances of developing acute kidney injury. Conclusion This study demonstrated a high kidney injury prevalence in young adults and its association with previous comorbidities. Obesity, kidney transplantation and chronic kidney disease increased the chance of young adults to develop acute kidney injury, resulting in outcomes in favor of morbidity and mortality.

17.
CoDAS ; 36(1): e20220291, 2024. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1520731

ABSTRACT

RESUMO Objetivo Avaliar o efeito imediato do inspirômetro de incentivo nas medidas acústicas, medidas aerodinâmicas e na avaliação perceptivo-auditiva da qualidade vocal de mulheres com vozes saudáveis. Método Trata-se de um estudo experimental de comparação intrassujeito que contou com a participação de 22 mulheres sem queixas vocais. Foram obtidas as medidas acústicas, medidas aerodinâmicas e a avaliação perceptivo-auditiva da qualidade vocal antes e imediatamente após o uso do inspirômetro de incentivo pelas participantes. O dispositivo foi utilizado na posição ortostática, e as participantes realizaram três séries de dez repetições com intervalo de um minuto entre as séries. Resultados Após uso do inspirômetro de incentivo, observou-se redução significativa nas medidas de jitter, shimmer e PPQ (period perturbation quociente) e aumento do volume expiratório máximo. As demais medidas acústicas e aerodinâmicas não foram impactadas significativamente. Além disso, houve melhora na avaliação perceptivo-auditiva da qualidade vocal em oito (36,4%) participantes, e 11 (50,0%) não apresentaram mudanças após uso do inspirômetro de incentivo. Conclusão O uso do inspirômetro de incentivo é seguro e, em seu efeito imediato, promove redução nas medidas acústicas de aperiodicidade a curto prazo, tanto relacionadas à frequência quanto à intensidade, e aumenta o volume expiratório máximo em mulheres com vozes saudáveis.


ABSTRACT Purpose To evaluate the immediate effect of the incentive spirometer on acoustic measures, aerodynamic measures and on the auditory-perceptual assessment of vocal quality in vocally healthy women. Methods This is an experimental intra-subject comparison study with the participation of 22 women without vocal complaints. Acoustic measures, aerodynamic measures and auditory-perceptual assessment of vocal quality were obtained before and immediately after using the incentive spirometer by the participants. The device was used in the orthostatic position and the participants performed three sets of ten repetitions with a one-minute interval between sets. Results After using the incentive spirometer, there was a significant reduction in jitter, shimmer and PPQ (period perturbation quotient) measurements and an increase in maximum expiratory volume, while the other acoustic and aerodynamic measurements were not significantly impacted. In addition, there was improvement in vocal quality in eight (36.4%) participants and 11 (50.0%) participants showed no changes in the auditory perceptual assessment of voice quality after using the incentive spirometer. Conclusion The use of the incentive spirometer is safe and, in its immediate effect, positively impacts the acoustic measures of short-term aperiodicity of frequency and intensity and increases the maximum expiratory volume in women with healthy voices.

18.
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;39(1): e20220434, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1521680

ABSTRACT

ABSTRACT Introduction: Acute aortic dissection Stanford type A (AADA) is a surgical emergency associated with high morbidity and mortality. Although surgical management has improved, the optimal therapy is a matter of debate. Different surgical strategies have been proposed for patients under 60 years old. This paper evaluates the postoperative outcome and the need for secondary aortic operation after a limited surgical approach (proximal arch replacement) vs. extended arch repair. Methods: Between January 2000 and January 2018, 530 patients received surgical treatment for AADA at our hospital; 182 were under 60 years old and were enrolled in this study - Group A (n=68), limited arch repair (proximal arch replacement), and group B (n=114), extended arch repair (> proximal arch replacement). Results: More pericardial tamponade (P=0.005) and preoperative mechanical resuscitation (P=0.014) were seen in Group A. More need for renal replacement therapy (P=0.047) was seen in the full arch group. Mechanical ventilation time (P=0.022) and intensive care unit stay (P<0.001) were shorter in the limited repair group. Thirty-day mortality was comparable (P=0.117). New onset of postoperative stroke was comparable (Group A four patients [5.9%] vs. Group B 15 patients [13.2%]; P=0.120). Long-term follow-up did not differ significantly for secondary aortic surgery. Conclusion: Even though young patients received only limited arch repair, the outcome was comparable. Full-arch replacement was not beneficial in the long-time follow-up. A limited approach is justified in the cohort of young AADA patients. Exemptions, like known Marfan syndrome and the presence of an intimal tear in the arch, should be considered.

19.
CoDAS ; 36(2): e20220323, 2024. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1557601

ABSTRACT

RESUMO Objetivo Apresentar um método de análise do modo respiratório por meio da termografia infravermelha. Método Estudo transversal exploratório de 38 imagens térmicas que representavam o momento da inspiração e da expiração durante a respiração nasal e durante a simulação da respiração oral de quatro voluntárias respiradoras nasais sem queixas respiratórias. Para a extração da temperatura das regiões de interesse (nariz e boca) foram utilizadas três formas de seleção distintas de dados (linha, retângulo e elipse) e três medidas de temperatura (mínima, média e máxima) por meio do software FLIR Tools®. Resultados Dentre as três formas de seleção houve maior variabilidade nas medidas obtidas pela linha, revelando limitações nessa medida. Não houve diferenças entre as medidas do retângulo e elipse, mostrando que ambas as formas de seleção apresentam resultados semelhantes para a extração das temperaturas. Na comparação entre as temperaturas do nariz e da boca na inspiração e expiração, os resultados indicaram que houve diferença com relevância estatística em todas as medidas realizadas, exceto para as medidas de temperatura média da inspiração, usando o retângulo e a elipse. Percebe-se diferenciação do modo respiratório tanto na inspiração quanto na expiração quando utilizada a temperatura média da boca com o retângulo e a elipse. Conclusão Sugere-se para avaliação do modo respiratório a avaliação da boca, por meio da elipse, com análise da temperatura média durante a inspiração.


ABSTRACT Purpose To present a method for analyzing breathing modes with infrared thermography. Methods This exploratory cross-sectional study used 38 thermal images of inspiration and expiration with nasal breathing and simulated mouth breathing in four nasal breathers without respiratory complaints. Three different data selection forms (line, rectangle, and ellipse) were used to extract the minimum, mean, and maximum temperatures of the regions of interest (nose and mouth) using the FLIR Tools® software. Results Among the three selection forms, there was greater temperature variability obtained with the line, revealing limitations in this measurement. There were no differences between the rectangle and ellipse values, showing that both selection forms present similar temperature extraction results. The comparison results between nose and mouth temperatures during inspiration and expiration indicated a statistically significant difference between all measurements, except for mean inspiration temperatures with the rectangle and ellipse. The breathing mode can be distinguished in both inspiration and expiration when using mean mouth temperatures with the rectangle and ellipse. Conclusion Breathing modes should be assessed based on mean mouth temperatures during inspiration, using the ellipse.

20.
CoDAS ; 36(4): e20230148, 2024. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1557631

ABSTRACT

RESUMO Objetivo Avaliar o efeito imediato do exercício inspiratório com incentivador e exercitador respiratório na voz de mulheres sem queixas vocais. Método Participaram 25 mulheres sem queixas vocais, entre 18 e 34 anos, com pontuação 1 no Índice de Triagem para Distúrbio Vocal (ITDV). A coleta de dados foi realizada nos momentos antes e após realização de exercício inspiratório e consistiu na gravação de vogal sustentada /a/, fala encadeada e tempos máximos fonatórios (TMF) de vogais, fonemas fricativos e contagem de números. No julgamento perceptivo-auditivo foi utilizada a Escala de Desvio Vocal (EDV) para verificar o grau geral do desvio vocal. Avaliação acústica foi feita no software PRAAT e foram extraídos os parâmetros frequência fundamental (f0), jitter, shimmer, proporção harmônico -ruído (HNR), Cepstral Peak Prominence Smoothed (CPPS), Acoustic Voice Quality Index (AVQI) e Acoustic Breathiness Index (ABI). Para mensuração das medidas aerodinâmicas, o tempo de emissão foi extraído no programa Audacity. Para comparar os resultados utilizou-se o teste paramétrico t de Student para amostras dependentes na análise das variáveis com distribuição normal e o teste de Wilcoxon para variáveis com distribuição não normal. Resultados Não houve diferenças entre os resultados do JPA e das medidas acústicas, nos momentos pré e pós exercício inspiratório. Quanto às medidas aerodinâmicas foi possível observar aumento significativo no valor do TMF /s/ (p=0,008). Conclusão Não houve modificação na qualidade vocal após o exercício inspiratório com incentivador e exercitador respiratório, porém foi observado aumento do TMF do fonema /s/ após a realização do exercício.


ABSTRACT Purpose To evaluate the immediate effect of the inspiratory exercise with a booster and a respiratory exerciser on the voice of women without vocal complaints. Methods 25 women with no vocal complaints, between 18 and 34 years old, with a score of 1 on the Vocal Disorder Screening Index (ITDV) participated. Data collection was performed before and after performing the inspiratory exercise and consisted of recording the sustained vowel /a/, connected speech and maximum phonatory times (MPT) of vowels, fricative phonemes and counting numbers. In the auditory-perceptual judgment, the Vocal Deviation Scale (VSD) was used to verify the general degree of vocal deviation. Acoustic evaluation was performed using the PRAAT software and the parameters fundamental frequency (f0), jitter, shimmer, harmonium-to-noise ratio (HNR), Cepstral Peak Prominence Smoothed (CPPS), Acoustic Voice Quality Index (AVQI) and Acoustic Breathiness Index (ABI). To measure the aerodynamic measurements, the time of each emission was extracted in the Audacity program. Data were statistically analyzed using the Statistica for Windows software and normality was tested using the Shapiro-Wilk test. To compare the results, Student's and Wilcoxon's t tests were applied, adopting a significance level of 5%. Results There were no significant differences between the results of the JPA and the acoustic measures, in the pre and post inspiratory exercise moments. As for the aerodynamic measures, it was possible to observe a significant increase in the value of the TMF /s/ (p=0.008). Conclusion There was no change in vocal quality after the inspiratory exercise with stimulator and respiratory exerciser, but an increase in the MPT of the phoneme /s/ was observed after the exercise.

SELECTION OF CITATIONS
SEARCH DETAIL