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Search Results: 1 - 10 of 23520 matches for " Jorge Ibrain Figueira; "
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Insuficiência adrenal relativa e uso de corticosteróides na sepse: estamos mais próximos de um consenso? Relative adrenal failure and the use of steroids in sepsis: are we closer to a consensus?
Jorge Ibrain Figueira Salluh,Anna Gabriela Fuks
Revista Brasileira de Terapia Intensiva , 2006, DOI: 10.1590/s0103-507x2006000100002
Preven o do delirium em pacientes críticos: um recome o? Prevention of delirium in critically ill patients: a new beginning?
Jorge Ibrain Figueira Salluh,Pratik Pandharipande
Revista Brasileira de Terapia Intensiva , 2012, DOI: 10.1590/s0103-507x2012000100001
Uso de biomarcadores na sepse: muitas perguntas, poucas respostas Use of biomarkers in sepsis: many questions, few answers
Pedro Póvoa,Jorge Ibrain Figueira Salluh
Revista Brasileira de Terapia Intensiva , 2013,
Atitutes e percep??es em terapia nutricional entre médicos intensivistas: um inquérito via internet
Cunha, Haroldo Falc?o Ramos da;Salluh, Jorge Ibrain Figueira;
Revista Brasileira de Terapia Intensiva , 2010, DOI: 10.1590/S0103-507X2010000100010
Abstract: objective: nutritional therapy is an important element in critical ill patient care. although recognized as specialty, multidisciplinary teams in nutrition support are scarce in our country. possibly, nutrition support therapy is applied by intensive care physicians and this may vary. the aim of the study is describe these specialists perceptions about theirs attitudes in enteral nutrition support. methods: a questionnaire was elaborated in an on-line platform. after pre-validation, it was sent by electronic mail to intensivists. in 30 days answers were collected, considering only the full-filled questionnaires. results: one hundred an fourteen forms were returned, 112 were analyzed. the responders were localized at majority in southeastern region. about beggining of nutritional support, the majority of answers reflect perceptions in accord to specialists societies recommendations. the responders' perception the frequent utilization of assistentials protocols in nutrition care. after support beginning, the responders perceptions about theirs participation in changes in therapeutic plan seems to be lower. the self-knowledge about the theme among the responders was 6.0 (arithmetic media) in a 1 to 10 scale. conclusions: more studies are necessary to evaluate nutritional support practices among intensive care physicians. alternatives to on-line platform should be considered. possibly, intensive care physicians do better in the initial phases of enteral support than in continuity of care. intensive care physicians knowledge about the issue is suboptimal.
The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies
Dimitri Gusmao-Flores, Jorge Ibrain Figueira Salluh, Ricardo Chalhub, Lucas C Quarantini
Critical Care , 2012, DOI: 10.1186/cc11407
Abstract: A systematic review was conducted to identify articles on the evaluation of the CAM-ICU and the ICDSC in ICU patients. A MEDLINE, SciELO, CINAHL and EMBASE databases search was performed for articles published in the English language, involving adult populations and comparing these diagnostic tools with the gold standard, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Results were summarized by meta-analysis. The QUADAS scale was used to assess the quality of the studies.Nine studies evaluating the CAM-ICU (including 969 patients) and four evaluating the ICDSC (n = 361 patients) were included in the final analysis. The pooled sensitivity of the CAM-ICU was 80.0% (95% confidence interval (CI): 77.1 to 82.6%), and the pooled specificity was 95.9% (95% CI: 94.8 to 96.8%). The diagnostic odds ratio was 103.2 (95% CI: 39.6 to 268.8). The pooled area under the summary receiver operating characteristic curve (AUC) was 0.97. The pooled sensitivity of the ICDSC was 74% (95% CI: 65.3 to 81.5%), and the pooled specificity was 81.9% (95% CI: 76.7 to 86.4%). The diagnostic odds ratio was 21.5 (95% CI: 8.51 to 54.4). The AUC was 0.89.The CAM-ICU is an excellent diagnostic tool in critically ill ICU patients, whereas the ICDSC has moderate sensitivity and good specificity. The available data suggest that both CAM-ICU and the ICDSC can be used as a screening tool for the diagnosis of delirium in critically ill patients.Delirium is a prevalent form of acute brain dysfunction that occurs in critically ill patients [1]. Despite its elevated frequency and association with increased morbidity and mortality [2], delirium remains an underdiagnosed condition in the intensive care unit (ICU), and a standard clinical evaluation does not have an adequate accuracy for the diagnosis [3]. Several methods have been developed and validated to diagnose delirium in ICU patients [4], but the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intens
Controle glicêmico em terapia intensiva 2009: sem sustos e sem surpresas
Pitrowsky, Melissa;Shinotsuka, Cassia Righy;Soares, Márcio;Salluh, Jorge Ibrain Figueira;
Revista Brasileira de Terapia Intensiva , 2009, DOI: 10.1590/S0103-507X2009000300012
Abstract: glucose control is a major issue in critical care since landmark publications from the last decade leading to widespread use of strict glucose control in the clinical practice. subsequent trials showed discordant results that lead to several questions and concerns about benefits and risks of implementing an intensive glucose control protocol. in the midst of all recent controversy, we propose that a new glycemic target -150mg/dl) should be aimed. this target glucose level could offer protection against the deleterious effects of hyperglycemia and at the same time keep patient's safety avoiding hypoglicemia. the article presents a critical review of the current literature on intensive insulin therapy in critically ill patients.
Drotrecogina alfa (ativada) na prática clínica e as evidências atuais: réplica Drotrecogin alfa (activated) in clinical practice and current evidences: reply
Márcio Soares,Fernando Osni Machado,Viviane Bogado Leite Torres,Jorge Ibrain Figueira Salluh
Revista Brasileira de Terapia Intensiva , 2008, DOI: 10.1590/s0103-507x2008000300018
Importancia da monitoriza??o do delirium na unidade de terapia intensiva
Pitrowsky, Melissa Tassano;Shinotsuka, Cássia Righy;Soares, Marcio;Lima, Marco Antonio Sales Dantas;Salluh, Jorge Ibrain Figueira;
Revista Brasileira de Terapia Intensiva , 2010, DOI: 10.1590/S0103-507X2010000300010
Abstract: delirium is an acute confusional state associated with increased mortality in the intensive care unit and long-term impaired functional recovery. despite its elevated incidence and major impact in the outcomes of critically ill patients, delirium remains under-diagnosed. presently, there are validated instruments to diagnose and monitor delirium, allowing the detection of early organ dysfunction and treatment initiation. beyond patient's non-modifiable risk factors, there are modifiable clinical and environmental aspects that should be accessed to reduce the occurrence and severity of delirium. as recent studies demonstrate that interventions aiming to reduce sedative exposure and to improve patients' orientation associated with early mobility have proved to reduce delirium, a low incidence of delirium should be targeted and considered as a measure of quality of care in the intensive care unit (icu).
Novos marcadores biológicos na pneumonia comunitária grave
Rabello, Lígia Sarmet Cunha Farah;Pitrowsky, Melissa Tassano;Soares, Márcio;Póvoa, Pedro;Salluh, Jorge Ibrain Figueira;
Revista Brasileira de Terapia Intensiva , 2011, DOI: 10.1590/S0103-507X2011000400016
Abstract: community-acquired pneumonia (cap) is the most common infectious disease requiring admission to intensive care units (icus), and achieving an early and precise diagnosis of cap remains a challenge. biomarkers play an important role in improving clinical judgment in the emergency room and are adjuvant in evaluating treatment responses. novel biomarkers, such as cortisol, pro-adrenomedullin and endothelin-1, have been shown to be associated with disease severity and short-term outcomes. this review article focuses on the clinical use of novel biomarkers, severity prediction and treatment monitoring as well as future directions of the field.
O uso da drotrecogina alfa ativada na prática clínica e as atuais evidências
Soares, Márcio;Machado, Fernando Osni;Torres, Viviane Bogado Leite;Salluh, Jorge Ibrain Figueira;Amaral, André Carlos Kajdacsy-Balla;
Revista Brasileira de Terapia Intensiva , 2008, DOI: 10.1590/S0103-507X2008000200010
Abstract: background and objectives: the debate on efficacy and patient safety related to the use of drotrecogin alfa (drotaa) is timely, principally due to the negative results observed in clinical studies performed after the prowess study, and the economic cost-related impact of the drug on the healthcare system. the aim of this study was to review the main studies on the use of drotaa in patients with severe sepsis. the focus was on drug efficacy-and patient safety-related issues. contents: articles were selected by a medline search for studies on the use of drotaa in patients with sepsis using the following key words: activated protein c; drotrecogin alfa; sepsis; septic shock; xigris?. additional references were retrieved from the studies initially selected. conclusions: mortality and bleeding complications associated with the use of drotaa were more frequent in large observational studies than those reported in randomized trials. in the light of the current knowledge, routine use of drotaa should be reevaluated until well-designed confirmatory clinical trials can clarify the true efficacy and safety of the drug and help identify the subgroup of patients that can benefit from use of drotaa. physicians should be cautious with the rapid transfer of evidences not well-documented, to the guidelines and recommendations practiced in the care and treatment of patients with severe sepsis.
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