Effect of a driving pressure-limiting strategy for patients with acute respiratory distress syndrome secondary to community-acquired pneumonia: the STAMINA randomised clinical trial.

Background: This study aimed to assess whether a driving pressure-limiting strategy based on positive end-expiratory pressure (PEEP) titration according to best respiratory system compliance and tidal volume adjustment increases the number of ventilator-free days within 28 days in patients with moderate to severe acute respiratory distress syndrome (ARDS).

Methods: This is a multi-centre, randomised trial, enrolling adults with moderate to severe ARDS secondary to community-acquired pneumonia. Patients were randomised to a driving pressure-limiting strategy or low PEEP strategy based on a PEEP:FiO table.

Prospective, randomized, controlled trial assessing the effects of a driving pressure-limiting strategy for patients with acute respiratory distress syndrome due to community-acquired pneumonia (STAMINA trial): protocol and statistical analysis plan.

Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear.

Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia.

Improved performance of an intensive care unit after changing the admission triage model.

The aim of this study is to analyze the effect of implementing a prioritization triage model for admission to an intensive care unit on the outcome of critically ill patients. Retrospective longitudinal study of adult patients admitted to the Intensive Care Unit (ICU) carried out from January 2013 to December 2017. The primary outcome considered was vital status at hospital discharge.

Early Tracheostomy May Reduce the Length of Hospital Stay.

Introduction: There is evidence that prolonged invasive mechanical ventilation has negative consequences for critically ill patients and that performing tracheostomy (TQT) could help to reduce these consequences. The ideal period for performing TQT is still not clear in the literature since few studies have compared clinical aspects between patients undergoing early or late TQT.

Objective: To compare the mortality rate, length of stay in the intensive care unit, length of hospital stay, and number of days free of mechanical ventilation in patients undergoing TQT before or after ten days of orotracheal intubation.

Refusal of beds and triage of patients admitted to intensive care units in Brazil: a cross-sectional national survey.

Objective: To obtain data on bed refusal in intensive care units in Brazil and to evaluate the use of triage systems by professionals.

Methods: A cross-sectional survey. Using the Delphi methodology, a questionnaire was created contemplating the objectives of the study.

Evaluation of time to death after admission to an intensive care unit and factors associated with mortality: A retrospective longitudinal study.

Background: Among nonsurvivors admitted to the intensive care unit (ICU), some present early mortality while other patients, despite having a favorable evolution regarding the initial disease, die later due to complications related to hospitalization. This study aims to identify factors associated with the time until death after admission to an ICU of a university hospital.

Methods: Retrospective longitudinal study that included adult patients admitted to the ICU between January 1, 2008, and December 31, 2017.

Seasonal variation of clinical characteristics and prognostic of adult patients admitted to an intensive care unit.

Objective: To evaluate seasonal variations of clinical characteristics, therapeutic resource use, and outcomes of critically ill patients admitted to an intensive care unit.

Methods: A retrospective cohort study conducted from January 2011 to December 2016 in adult patients admitted to the intensive care unit (ICU) of a University Hospital. Data were collected on the type of admission, APACHE II, SOFA, and TISS 28 scores at ICU admission.

The Effect of Support Surfaces on the Incidence of Pressure Injuries in Critically Ill Patients: A Randomized Clinical Trial.

Purpose: To analyze whether a viscoelastic mattress support surface can reduce the incidence of stage 2 pressure injuries compared to a standard hospital mattress with pyramidal overlay in critically ill patients.

Method: A randomized clinical trial with intention-to-treat analysis was carried out recruiting patients with Braden scale ≤14 on intensive care unit admission from April 2016 to April 2017. Patients were allocated into two groups: intervention group (viscoelastic mattress) and control group (standard mattress with pyramidal overlay).

Evaluation of the five-year operation period of a rapid response team led by an intensive care physician at a university hospital.

Objective: To evaluate the implementation of a multidisciplinary rapid response team led by an intensive care physician at a university hospital.

Methods: This retrospective cohort study analyzed assessment forms that were completed during the assessments made by the rapid response team of a university hospital between March 2009 and February 2014.

Results: Data were collected from 1,628 assessments performed by the rapid response team for 1,024 patients and included 1,423 code yellow events and 205 code blue events.