Effects of physical therapy with neuromuscular electrical stimulation in acute and late septic shock patients: A randomised crossover clinical trial.

Background: Patients with sepsis and immobility in the intensive care unit are associated with muscle weakness, and early mobilisation can counteract it. However, during septic shock, mobilisation is often delayed due to the severity of the illness. Neuromuscular electrical stimulation (NMES) may be an alternative to mobilise these patients early.

The perceived barriers and facilitators to implementation of early mobilisation within a multicentre, phase 3 randomised controlled trial: A qualitative process evaluation study.

Background: Process evaluation within clinical trials provides an assessment of the study implementation's accuracy and quality to explain causal mechanisms and highlight contextual factors associated with variation in outcomes.

Objectives: This study aimed to identify the barriers and facilitators of implementing early mobilisation (EM) within a trial.

Methods: This is a qualitative process evaluation study within the Trial of Early Activity and Mobilisation (TEAM) phase 3 randomised controlled trial.

The use of distributed random forest model to quantify risk predictors for tracheostomy requirements in septic patients: A retrospective cohort study.

The search for early clinical risk factors in the intensive care setting may improve the outcome of critically ill patients. The objective of this retrospective study is to identify and quantify early predictors for patients who would require tracheostomy. Five hundred and forty four septic patients were divided in 2 groups: non-tracheostomized (NT) (n = 484) and tracheostomized (T) (n = 60).

Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients: A retrospective cohort study.

The knowledge of weaning ventilation period is fundamental to understand the causes and consequences of prolonged weaning. In 2007, an International Consensus Conference (ICC) defined a classification of weaning used worldwide. However, a new definition and classification of weaning (WIND) were suggested in 2017.

The use of APACHE II, SOFA, SAPS 3, C-reactive protein/albumin ratio, and lactate to predict mortality of surgical critically ill patients: A retrospective cohort study.

Several prognostic indices have been employed to predict the outcome of surgical critically ill patients. Among them, acute physiology and chronic health evaluation (APACHE) II, sequential organ failure assessment (SOFA) and simplified acute physiology score (SAPS 3) are widely used. It seems that biological markers such as C-reactive protein (CRP), albumin, and blood lactate levels correlate with the degree of inflammation during the immediate postoperative phase and could be used as independent predictors.

The use of SAPS 3, SOFA, and Glasgow Coma Scale to predict mortality in patients with subarachnoid hemorrhage: A retrospective cohort study.

Guidelines for patients with subarachnoid hemorrhage (SAH) management and several grading systems or prognostic indices have been used not only to improve the quality of care but to predict also the outcome of these patients. Among them, the gold standards Fisher radiological grading scale, Hunt-Hess and the World Federation of Neurological Surgeons (WFNS) are the most employed. The objective of this study is to compare the predictive values of simplified acute physiology score (SAPS) 3, sequential organ failure assessment (SOFA), and Glasgow Coma Scale (GCS) in the outcome of patients with aneurysmal SAH.

The effects of physical therapy with neuromuscular electrical stimulation in patients with septic shock: Study protocol for a randomized cross-over design.

Introduction: Septic shock is a potentially fatal organ dysfunction caused by an imbalance of the host response to infection. The changes in microcirculation during sepsis can be explained by the alterations in the endothelial barrier function. Endothelial progenitor cells (EPCs) are a potential recovery index of endothelial function and it an increase in response to neuromuscular electrical stimulation (NMES) was demonstrated.

How Mechanical Ventilation Measurement, Cutoff and Duration Affect Rapid Shallow Breathing Index Accuracy: A Randomized Trial.

Background: Decreased accuracy of the rapid shallow breathing index (RSBI) can stem from 1) the method used to obtain this index, 2) duration of mechanical ventilation (MV), and 3) the established cutoff point. The objective was to evaluate the values of RSBI determined by three different methods, using distinct MV times and cutoff points.

Methods: This prospective study included 40 subjects.

Are the Dysnatremias a Permanent Threat to the Critically Ill Patients?

Backgroud: The dysnatremias (hyponatremia and hypernatremia) are relatively common findings on admission of intensive care unit (ICU) patients and may represent a major risk. The aim of the study was to assess the ability of serum sodium levels and the Acute Physiology and Chronic Health Evaluation II (APACHE II) to predict mortality of surgical critically ill patients.

Methods: One hundred and ninety-five surgical patients (62% males and 38% females; mean age of 51.

Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients.

Background: In routine practice, assessment of the nutritional status of critically ill patients still relies on traditional methods such as anthropometric measurements, biochemical markers, and predictive equations.

Objective: To compare resting energy expenditure measured by indirect calorimetry (REEIC) with REE calculated by using the Harris-Benedict equation with 3 different sources of body weight (from bed scale, REEHB1; ideal body weight, REEHB2; and predicted body weight, REEHB3).

Methods: This study included 205 critically ill patients (115 men, 90 women) evaluated within the first 48 hours of admission and undergoing mechanical ventilation.

Comparison of Energy Expenditure and Oxygen Consumption of Spontaneous Breathing Trial Conducted With and Without Automatic Tube Compensation.

Background: Weaning from mechanical ventilation is defined as the process of release of ventilatory support and how the evaluation of this phase is conducted in the spontaneous breathing trial (SBT). One of the most used modes of SBT is the continuous positive airway pressure (CPAP), which applies a continuous positive pressure in both inspiration and expiration. However, together with the mechanical ventilation modes, the automatic tube compensation (ATC) can be used, which compensates the resistance imposed by the endotracheal tube.

Energy expenditure in critically ill surgical patients. Comparative analysis of predictive equation and indirect calorimetry.

Purpose: The aim of this investigation was to compare the resting energy expenditure (REE) calculated by the Harris-Benedict equation (REE HB) with the REE measured by indirect calorimetry (REE IC) in critically ill surgical patients under mechanical ventilation.

Methods: Thirty patients were included in this work. REE was calculated by the Harris-Benedict equation (REE HB) using real body weight, and it was also measured by indirect calorimetry (REE IC), which was performed for 30 minutes.