Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Publication continuous and bimonthly

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Empyema caused by infection with Clostridium septicum in a patient with lung cancer

Empiema causado por infecção por Clostridium septicum em um paciente com câncer de pulmão

Gabriel Afonso Dutra Kreling1,a, Marilia Ambiel Dagostin1,b, Marcelo Park2,c

J Bras Pneumol.2018;44(6):529-531

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Mobility therapy and central or peripheral catheter-related adverse events in an ICU in Brazil

Realização de fisioterapia motora e ocorrência de eventos adversos relacionados a cateteres centrais e periféricos em uma UTI brasileira

Natália Pontes Lima1, Gregório Marques Cardim da Silva1, Marcelo Park2, Ruy Camargo Pires-Neto3

J Bras Pneumol.2015;41(3):225-230

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Objective: To determine whether mobility therapy is associated with central or peripheral catheter-related adverse events in critically ill patients in an ICU in Brazil. Methods: A retrospective analysis of the daily medical records of patients admitted to the Clinical Emergency ICU of the University of São Paulo School of Medicine Hospital das Clínicas Central Institute between December of 2009 and April of 2011. In addition to the demographic and clinical characteristics of the patients, we collected data related to central venous catheters (CVCs), hemodialysis (HD) catheters and indwelling arterial catheters (IACs): insertion site; number of catheter days; and types of adverse events. We also characterized the mobility therapy provided. Results: Among the 275 patients evaluated, CVCs were used in 49%, HD catheters were used in 26%, and IACs were used in 29%. A total of 1,268 mobility therapy sessions were provided to patients while they had a catheter in place. Catheter-related adverse events occurred in 20 patients (a total of 22 adverse events): 32%, infection; 32%, obstruction; and 32%, accidental dislodgement. We found that mobility therapy was not significantly associated with any catheter-related adverse event, regardless of the type of catheter employed: CVC-OR = 0.8; 95% CI: 0.7-1.0; p = 0.14; HD catheter-OR = 1.04; 95% CI: 0.89-1.21; p = 0.56; or IAC-OR = 1.74; 95% CI: 0.94-3.23; p = 0.07. Conclusions: In critically ill patients, mobility therapy is not associated with the incidence of adverse events involving CVCs, HD catheters, or IACs.

 


Keywords: Physical therapy modalities; Intensive care units; Catheters; Early ambulation.

 


Extracorporeal respiratory support in adult patients

Suporte respiratório extracorpóreo em pacientes adultos

Thiago Gomes Romano1,3, Pedro Vitale Mendes2,3, Marcelo Park2, Eduardo Leite Vieira Costa3,4

J Bras Pneumol.2017;43(1):60-70

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In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support. We discuss the history of respiratory support using ECMO in adults, as well as the clinical evidence; costs; indications; installation of the equipment; ventilator settings; daily care of the patient and the system; common troubleshooting; weaning; and discontinuation.

 


Keywords: Extracorporeal membrane oxygenation; Respiratory distress syndrome, adult; Hypoxia; Hypercapnia.

 


 

 


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CNPq, Capes, Ministério da Educação, Ministério da Ciência e Tecnologia, Governo Federal, Brasil, País Rico é País sem Pobreza
Secretariat of the Brazilian Journal of Pulmonology
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E-mails: jbp@jbp.org.br
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