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Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of RIIS: Revista de Investigação & Inovação em Saúde is the property of RIIS: Revista de Investigacao & Inovacao em Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: In March 2020, the WHO officially declared the COVID-19 outbreak a pandemic. Generally, the lungs are one of the first organs to be affected and NIV plays an important role in the management of respiratory failure in various pathologies, and can be a strategy in the treatment of complications related to COVID-19 infection. Aim: To analyze the profile of patients hospitalized with COVID-19 and the indications for the use of NIV. Methods: This is a retrospective observational study, with analysis of medical records from July 2020 to December 2021 of a tertiary public hospital in the Federal District. Results: Acute Respiratory Failure was the most frequent indication for the use of NIV, and we can observe that failure to use NIV was associated with the persistence of severe respiratory symptoms, being related to longer ICU stay and hospital stay. Conclusion: Non-Invasive Ventilation may have contributed as an intervention in the treatment of ARF in COVID-19, patients who were successful in NIV had a shorter hospital stay, as well as lower mortality. [ABSTRACT FROM AUTHOR]

Copyright of Minas Gerais Medical Journal / Revista Médica de Minas Gerais is the property of Associacao Medica de Minas Gerais and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Ventilatory support is used for the treatment of patients with acutely chronic or acute respiratory failure (ARF). Noninvasive ventilation (NIV) in pediatric ARF is widely used in preterm infants and children, but studies to date have been limited. Therefore, the aim of the present study was to determine the risk factors associated with NIV failure in a pediatric intensive care unit. Methods: This retrospective cohort study was based on medical records of patients admitted to the pediatric intensive care unit of a hospital in Caxias do Sul, southern Brazil, between May 2017 and October 2019, who used NIV. Results: The incidence of NIV failure was 33%. Asthma (relative risk [RR] = 1.36; 95% confidence interval [CI] = 1.08-1.72), post-extubation use of NIV (RR = 1.97; 95% CI = 1.17-3.29), continuous use of NIV (RR = 2.44; 95% CI = 1.18-5.05), completion at night (RR = 2.52; 95% CI = 1.53-4.14), final mode synchronized intermittent mandatory ventilation (SIMV) (RR = 4.20; 95% CI = 2.20-7.90), positive end-expiratory pressure at the beginning of ventilation (6.8 ± 1.1; p < 0.01), and final fraction of inspired oxygen (53.10 ± 18.50; p < 0.01) were associated with failure. Additionally, initial systolic blood pressure (118.68 ± 18.68 mmHg; p = 0.02), initial respiratory rate (IRR) (47.69 ± 14.76; p = 0.28), and final respiratory rate (47.54 ± 14.76; p < 0.01) were associated with failure. Conclusion: The final ventilatory mode SIMV proves to be the best failure risk predictor, followed by the shift in which NIV is completed, as there is a greater risk of failure at night. In addition, final positive inspiratory pressure and final respiratory rate were less robust predictors of failure. [ABSTRACT FROM AUTHOR]

Pneumonitis is inflammation of the lungs, caused by bacteria, viruses, fungi and allergic reactions, which can affect the region of the pulmonary alveoli where gas exchange occurs. Mechanical ventilation (MV) is a supportive method for the treatment of patients with Acute Respiratory Failure (ARF) or acute chronic. It aims to assess the incidence, risk factors, prevention and nursing care of patients with ventilator-associated pneumonia admitted to the ICU. This is a bibliographic search based on current publications and systematic searches using the following databases: MEDLINE, LILACS, SciELO, Cochrane Library, which include scientific articles, dissertations, monographs, in addition to other scientific research. Based on these considerations, the training of the multidisciplinary team qualifies and reinforces the importance of the procedure, so that the team and managers assume a continuous commitment to the prevention of Pneumonia associated with MV in the ICU. [ABSTRACT FROM AUTHOR]

Introduction: Ventilatory support is used for the treatment of patients with acutely chronic or acute respiratory failure (ARF). Noninvasive ventilation (NIV) in pediatric ARF is widely used in preterm infants and children, but studies to date have been limited. Therefore, the aim of the present study was to determine the risk factors associated with NIV failure in a pediatric intensive care unit. Methods: This retrospective cohort study was based on medical records of patients admitted to the pediatric intensive care unit of a hospital in Caxias do Sul, southern Brazil, between May 2017 and October 2019, who used NIV. Results: The incidence of NIV failure was 33%. Asthma (relative risk [RR] = 1.36; 95% confidence interval [CI] = 1.08-1.72), post-extubation use of NIV (RR = 1.97; 95% CI = 1.17-3.29), continuous use of NIV (RR = 2.44; 95% CI = 1.18-5.05), completion at night (RR = 2.52; 95% CI = 1.53-4.14), final mode synchronized intermittent mandatory ventilation (SIMV) (RR = 4.20; 95% CI = 2.20-7.90), positive end-expiratory pressure at the beginning of ventilation (6.8 ± 1.1; p < 0.01), and final fraction of inspired oxygen (53.10 ± 18.50; p < 0.01) were associated with failure. Additionally, initial systolic blood pressure (118.68 ± 18.68 mmHg; p = 0.02), initial respiratory rate (IRR) (47.69 ± 14.76; p = 0.28), and final respiratory rate (47.54 ± 14.76; p < 0.01) were associated with failure. Conclusion: The final ventilatory mode SIMV proves to be the best failure risk predictor, followed by the shift in which NIV is completed, as there is a greater risk of failure at night. In addition, final positive inspiratory pressure and final respiratory rate were less robust predictors of failure. [ABSTRACT FROM AUTHOR]

Objective: to analyze, in the scientific literature, the knowledge available on the use of the prone position in pregnant women diagnosed with COVID-19 or other health conditions. Method: an integrative literature review developed through the following guiding question: What is the scientific knowledge available on the use of the prone position in pregnant women with COVID-19 or other health conditions? The search for studies was carried out in eight databases. Results: using the prone position in pregnant women with Acute Respiratory Distress syndrome allowed for improvements in lung compliance and oxygenation. It also allowed reducing uterine compression on the maternal large vessels, and a reduction in blood pressure was observed in pregnant women with pre-eclampsia. The prone position was also safe in the surgical management of pregnant patients. In addition, the following conditions stood out as disadvantages related to the prone position in pregnant women: possibility of aortocaval compression, causing severe hypotension, and inability to easily monitor fetal status or to perform emergency Cesarean sections. Conclusion: the prone position was considered safe, reliable and comfortable for its use in the clinical management of pregnant women, where specific care measures must be taken to avoid compression of gravid abdomen, as well as fetal monitoring is important to detect placental circulation impairment.

Objective: To evaluate the effectiveness of educational intervention in the intensive care process, at the level of knowledge of the nursing team about the prone position in patients with acute respiratory distress syndrome. Methods: This is a quasi-experimental quantitative study, with a sample of 62 professionals from the intensive sector. Data was collected on the variable knowledge of professionals during the pre- and post-educational intervention phase, for a week, through the application of multiple choice forms. For data analysis and evaluation of the effectiveness of educational intervention, descriptive statistics and Kolmogorov-Smirnova and Shapiro Wilk tests were used to prove normality and the Student T test to compare the averages obtained. Results: When comparing the averages obtained in the pre and post educational intervention phases, it was observed that the average of correct answers before intervention was 6.12, while in the post intervention 9.43. Conclusion: The effectiveness of the educational intervention in the intensive care process was found to be about the knowledge of nursing professionals about the prone position, considering a significant increase in the score of correct answers obtained in the post-intervention phase. Thus, continuing education in intensive sectors, becomes essential for the purposes of professional development. [ABSTRACT FROM AUTHOR]

Spontaneous breathing can be deleterious in patients with previously injured lungs, especially in acute respiratory distress syndrome. Moreover, the failure to assume spontaneous breathing during mechanical ventilation and the need to switch back to controlled mechanical ventilation are associated with higher mortality. There is a gap of knowledge regarding which parameters might be useful to predict the risk of patient self-inflicted lung injury and to detect the inability to assume spontaneous breathing. We report a case of patient self-inflicted lung injury, the corresponding basic and advanced monitoring of the respiratory system mechanics and physiological and clinical results related to spontaneous breathing. The patient was a 33-year-old Caucasian man with a medical history of AIDS who developed acute respiratory distress syndrome and needed invasive mechanical ventilation after noninvasive ventilatory support failure. During the controlled ventilation periods, a protective ventilation strategy was adopted, and the patient showed clear clinical and radiographic improvement. However, during each spontaneous breathing period under pressure support ventilation, despite adequate initial parameters and a strictly adjusted ventilatory setting and monitoring, the patient developed progressive hypoxemia and worsening of respiratory system mechanics with a clearly correlated radiographic deterioration (patient self-inflicted lung injury). After failing three spontaneous breathing assumption trials, he died on day 29 due to refractory hypoxemia. Conventional basic and advanced monitoring variables in this case were not sufficient to identify the aptitude to breathe spontaneously or to predict the risk and development of patient self-inflicted lung injury during partial support ventilation. [ABSTRACT FROM AUTHOR]

This case report describes the physiotherapeutic management in the invasive mechanical ventilatory assistance of a patient with pulmonary hypertension secondary to severe acute respiratory distress syndrome (ARDS). The patient, a one-month-old child, was admitted due to prematurity and presented worsening signs of respiratory distress, being diagnosed with acute viral bronchiolitis, pneumonia, severe ARDS, and secondary pulmonary hypertension. The medical team used protective ventilatory strategies, alveolar recruitment maneuvers, vasoactive drugs, and sedoanalgesia to prevent pulmonary and systemic damage. The patient successfully reversed the complications and was able to be weaned off ventilatory parameters before discharge. The precise assistance of the physiotherapist was crucial in reducing recovery time and improving post-hospital quality of life. [Extracted from the article]

This article presents a protocol for pediatric prone positioning, which is crucial for patients with Acute Respiratory Distress Syndrome and other severe conditions. The protocol addresses the preparation, positioning, monitoring, and repositioning of critical pediatric patients, with the aim of standardizing the execution and providing clear guidelines on prone positioning. A checklist has been created to ensure the safety of the procedure, including patient preparation, verification of probe and catheter positions, application of protective dressings, and execution of the maneuver. The protocol aims to improve the quality of care and reduce risks for the patient. [Extracted from the article]

Objective: to describe scientific evidence regarding the use of prone positioning in the care provided to patients with acute respiratory failure caused by COVID-19. Method: this is a scoping review. PRISMA Extension for Scoping Reviews was used to support the writing of this study. The search was conducted in seven databases and resulted in 2,441 studies, 12 of which compose the sample. Descriptive statistics, such as relative and absolute frequencies, was used to analyze data. Results: prone positioning was mainly adopted in Intensive Care Units, lasted from a minimum of 12 up to 16 hours, and its prescription was based on specific criteria, such as PaO2/FiO2 ratio, oxygen saturation, and respiratory rate. The most prevalent complications were: accidental extubation, pressure ulcer, and facial edema. Decreased hypoxemia and mortality rates were the main outcomes reported. Conclusion: positive outcomes outweighed complications. Various cycles of prone positioning are needed, which may cause potential work overload for the health staff. Therefore, an appropriate number of trained workers is necessary, in addition to specific institutional protocols to ensure patient safety in this context.

Objective: To associate the hypertensive gestational syndromes (SHEG) with acute respiratory distress in newborns (RN). Methods: A prospective, cross-sectional study of 130 puerperal women with SHEG and 142 newborns. Data were collected by means of a questionnaire between June and September 2018. It was used the Yates chi-square test and Fisher's exact test. Results: The most prevalent diagnosis of SHEG was preeclampsia (48,46%). Premature newborns were predominating (62,68%), who needed neonatal intensive care (61,36%). The diagnosis of preeclampsia was associated with prematurity (0.01744), low weight (0.009306), respiratory distress (<0.0000001) and use of ventilatory support (<0.0000001), and overlapping preeclampsia was associated with respiratory distress (0.0006261) and the use of ventilatory support (0.0006261). Conclusion: It is important to identify early SHEG and provide quality care during the pregnancy process to reduce unfavorable neonatal outcomes and the infant mortality rate. [ABSTRACT FROM AUTHOR]

Objective: to describe nursing diagnoses and interventions to children with respiratory signs of COVID-19 severity. Method: exploratory, descriptive, narrative review study, conducted in June 2020, based on scientific evidence published in the PUBCOVID-19 database, for further preparation of diagnoses using the North American Nursing Diagnoses Association - International Taxonomy, and interventions anchored in the Nursing Interventions Classification. Results: dyspnea and respiratory distress were the most evident signs of severity in children with COVID-19. Three main diagnostic statements were elaborated: Impaired Gas Exchange, Ineffective Respiratory Pattern and Impaired Spontaneous Ventilation, with 24 Nursing Interventions corresponding in four domains: physiological, behavioral, safety, and family. Conclusion: the description of nursing diagnoses and interventions, anchored by NANDA and NIC taxonomies, respectively, presents innovation in the Brazilian scientific literature. [ABSTRACT FROM AUTHOR]

The disease COVID-19 caused by the coronavirus SARS-CoV-2 translates, in individuals affected by this virus, from mild respiratory symptoms, sometimes imperceptible to serious respiratory and multiorgan implications, especially if associated with risk groups such as people with hypertension, diabetes or those with more than 65 years, among others. For the most severely affected patients, hospitalization in intensive care units due to severe respiratory distress syndrome may be a reality, with increased hospitalization time compared to normal pneumonia, and which will translate into motor and functional sequelae where the physiotherapist will have an essential role to develop. In any of the different stages of evolution of this disease (critical and acute, post-acute, ambulatory, and home), the physiotherapist acts in order to restore maximum functional capacity in individuals affected by COVID-19. The purpose of this text is thus to show the role of the physiotherapist in each of these intervention stages. [ABSTRACT FROM AUTHOR]

Mechanical ventilation (MV) is widely used in hospitals or in intensive care units in patients with acute respiratory failure (ARF). The efficiency of mechanical ventilation depends on frequent manual adjustments by trained professionals and in accordance with the patient's physiological signals. This task implies a specialized, constant and exhaustive work. This paper proposes an artificial neural network (RNA) model for automatic parametrization of the mechanical ventilator aiming to maintain adequate ventilation of the patient plus the optimization of human resources in the health area. [ABSTRACT FROM AUTHOR]

Resumo Objetivo O objetivo deste estudo foi avaliar o impacto do aumento de pressão positiva no fim da expiração (PEEP) sobre a microcirculação sublingual. Métodos Os pacientes adultos que foram sedados, sob ventilação mecânica, com diagnóstico de choque circulatório e síndrome do desconforto respiratório agudo foram incluídos. O nível da PEEP foi estabelecido para obter uma pressão de platô de 30 cmH 2 O e depois mantido nesse nível por 20 minutos. As variáveis de microcirculação (obtida por microscopia de vídeo) e hemodinâmica foram registradas na fase basal e comparadas com aquelas no fim de 20 min. Resultados Doze pacientes foram incluídos. Em geral, os parâmetros da microcirculação não apresentaram alterações significativas após o aumento da PEEP. Porém, houve considerável variabilidade interindividual. Houve uma correlação negativa, moderada, entre as alterações no escore de De Backer (r = ‐0,58, p = 0,048), na densidade total do vaso (r = ‐0,60, p = 0,039) e nos valores basais. As alterações na densidade total do vaso (r = 0,54, p = 0,07) e na densidade do vaso perfundido (r = 0,52, p = 0,08) apresentaram tendência de correlação com as alterações na pressão arterial média. Conclusão Em geral, os parâmetros da microcirculação não apresentaram alterações significativas após o aumento da PEEP. No entanto, individualmente, essa resposta foi heterogênea. As alterações nos parâmetros da microcirculação puderam ser correlacionadas com os valores basais e alterações na pressão arterial média. Objective The aim of this study was to evaluate the impact of increased positive end‐expiratory pressure on the sublingual microcirculation. Methods Adult patients who were sedated, under mechanical ventilation, and had a diagnosis of circulatory shock and acute respiratory distress syndrome were included. The positive end‐expiratory pressure level was settled to obtain a plateau pressure of 30 cmH 2 O and then maintained at this level for 20 minutes. Microcirculatory (obtained by videomicroscopy) and hemodynamic variables were collected at baseline and compared with those at the end of 20 min. Results Twelve patients were enrolled. Overall, the microcirculation parameters did not significantly change after increasing the positive end‐expiratory pressure. However, there was considerable interindividual variability. There was a negative, moderate correlation between the changes in the De Backer score ( r = ‐ 0.58, p = 0.048), total vessel density ( r = ‐ 0.60, p = 0.039) and baseline values. The changes in total vessel density ( r = 0.54, p = 0.07) and perfused vessel density ( r = 0.52, p = 0.08) trended toward correlating with the changes in the mean arterial pressure. Conclusion Overall, the microcirculation parameters did not significantly change after increasing the positive end‐expiratory pressure. However, at individual level, such response was heterogeneous. The changes in the microcirculation parameters could be correlated with the baseline values and changes in the mean arterial pressure. [ABSTRACT FROM AUTHOR]

SDRA is characterized by diffuse inflammation of the alveolar capitar, in response to various pulmonary or extrapul-monary risk factors, divided into: light oxygen tension/fraction of inspired oxygen (PaO2 / FiO2) between 200 and 300 mmHg with positive end-expiratory pressure (PEEP) or positive airway pressure continues CPAP> 5 cm H2O, moderate PaO2 / FiO2 between 100 and 200 mmHg with PEEP> 5 cm H2O and severe with PaO2 / FiO2 below 100 mmHg with PEEP> 5 cmH2O. The MRA can be used in the treatment must be performed within 72 hours. Different methods are proposed: sustained inflation with high levels of CPAP; simultaneous increase in PEEP and tidal volume; progressive increase in PEEP with a fixed value of IP (inspiratory pressure) and simultaneous lifting of IP and PEEP ventilation mode controlled pressure. To compare the effects of different alveolar recruitment techniques in SDRA. This is a systematic review. Surveys were used in scientific journals and databases: Medline, Scielo, Peter and Pubmed. In the period 1998 to 2015. Of the 1150 articles that were found, 13 were selected which contemplated the chosen criteria. The 13 selected articles all found the effectiveness of maneuvers in SDRA and described alveolar recruitment maneuvers, and in three articles to improved gas exchange after the maneuvers was only momentary. MRA are effective in the treatment of SDRA, however their efficacy occurs at the initial stage. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Pulmonology / Jornal Brasileiro de Pneumologia is the property of Sociedade Brasileira de Pneumologia e Tisiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Jornal de Pediatria is the property of Sociedade Brasileira de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute Respiratory Distress Syndrome (ARDS) is a sharp lesion characterized mainly for lung swelling causing hypoxemia and breathing insufficiency. The ventilation support has as objective improved the patient oxygenation. The prone position is used to improve the relationship between perfusion and ventilation, increasing the lung volume, decreasing the effect of the heart area on the lungs. That position decreases the atelectasis and improves the oxygenation. Therefore the objctive of this work is to give prominence to the benefits which the prone position it provides to the patient with ARDS. A study was accomplished through literary revision in books and goods online, using the terms: prone position, acute respiratory distress syndrome,oxygenation selected in agreement with his/her relevance for the study. All the studies are in favor of the use of the prone position as efficient method in I assist it of the treatment of the patient with ARDS. [ABSTRACT FROM AUTHOR]

Mycoplasma pneumoniae was recognized as an important agent of pneumonia in pediatric population. In rare situations, severe pulmonary injury can develop. The use of corticoids in these cases remains controversial. A case of a girl with acute respiratory distress syndrome and bilateral pleural effusion secondary to pneumonia due to Mycoplasma pneumoniae is described, with good recovery after appropriate use of methylprednisolone and clarythromicyn. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the impact of increased positive end-expiratory pressure on the sublingual microcirculation., Methods: Adult patients who were sedated, under mechanical ventilation, and had a diagnosis of circulatory shock and acute respiratory distress syndrome were included. The positive end-expiratory pressure level was settled to obtain a plateau pressure of 30cmH 2 O and then maintained at this level for 20minutes. Microcirculatory (obtained by videomicroscopy) and hemodynamic variables were collected at baseline and compared with those at the end of 20min., Results: Twelve patients were enrolled. Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, there was considerable interindividual variability. There was a negative, moderate correlation between the changes in the De Backer score (r=-0.58, p=0.048), total vessel density (r=-0.60, p=0.039) and baseline values. The changes in total vessel density (r=0.54, p=0.07) and perfused vessel density (r=0.52, p=0.08) trended toward correlating with the changes in the mean arterial pressure., Conclusion: Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, at individual level, such response was heterogeneous. The changes in the microcirculation parameters could be correlated with the baseline values and changes in the mean arterial pressure., (Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)