Cássia Righy Shinotsuka

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INTRODUCTION Delirium and coma are a frequent source of morbidity for ICU patients. Several factors are associated with the prognosis of mechanically ventilated (MV) cancer patients, but no studies evaluated delirium and coma (acute brain dysfunction). The present study evaluated the frequency and impact of acute brain dysfunction on mortality. METHODS(More)
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(More)
OBJECTIVES Our aim was to review the literature on the prevalence and impact of critical-illness related corticosteroid insufficiency (CIRCI) on the outcomes of patients with severe community-acquired pneumonia (CAP). METHODS We reviewed Cochrane, Medline, and CINAHL databases (through July 2008) to identify studies evaluating the adrenal function in(More)
A significant number of landmark studies have been published in the last decade that increase the current knowledge on sedation for critically ill patients. Therefore, many practices that were considered standard of care are now outdated. Oversedation has been shown to be hazardous, and light sedation and no-sedation protocols are associated with better(More)
EDITORIAL Sedation strategies in intensive care units (ICU) have changed over the past decade towards daily wake-up calls, less sedation and even no sedation. Furthermore, new ventilatory modes were designed to promote better patient synchrony with the ventilator and fewer sedation requirements. It is well known that the strategies used to reduce sedation(More)
EDITORIAL Sedation and analgesia are frequently used in the critical care unit. Pain has already been described as the " fifth vital sign, " and most people describe experiencing pain as a source of great stress during an intensive care unit (ICU) stay. Sedation can be used to ease discomfort, to facilitate adaptation to mechanical ventilation, and to(More)
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(More)
OBJECTIVES Sepsis is the main cause of death in the intensive care unit. New preventive measures for nosocomial infections have been researched, such as pre, pro and symbiotic usage, due to its immunoregulatory properties. The objective was to evaluate the effect of administration of pre, pro and symbiotic on gastrointestinal and inferior airway(More)
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