Amanda Sachetti

Adesão às medidas de um bundle para prevenção de pneumonia associada à ventilação mecânica

Objective To assess adherence to a ventilator care bundle in an intensive care unit and to determine the impact of adherence on the rates of ventilatorassociated pneumonia. Methods A total of 198 beds were assessed for 60 days using a checklist that consisted of the following items: bed head elevation to 30 to 45º; position of the humidifier filter; lack of fluid in the ventilator circuit; oral hygiene; cuff pressure; and physical therapy. Next, an educational lecture was delivered, and 235 beds were assessed for the following 60 days. Data were also collected on the incidence of ventilator-acquired pneumonia. Results Adherence to the following ventilator care bundle items increased: bed head elevation from 18.7% to 34.5%; lack of fluid in the ventilator circuit from 55.6% to 72.8%; oral hygiene from 48.5% to 77.8%; and cuff pressure from 29.8% to 51.5%. The incidence of ventilator-associated pneumonia was statistically similar before and after intervention (p=0.389). Conclusion The educational intervention performed in this study increased the adherence to the ventilator care bundle, but the incidence of ventilator-associated pneumonia did not decrease in the small sample that was assessed.

Use of neuromuscular electrical stimulation to preserve the thickness of abdominal and chest muscles of critically ill patients : a randomized clinical trial

OBJECTIVE To evaluate and compare the effects of neuromuscular electrical stimulation combined with conventional physical therapy on muscle thickness in critically ill patients. DESIGN Double-blind, randomized controlled trial. PATIENTS Twenty-five patients participated in the study. METHODS Patients on mechanical ventilation for 24-48 h were randomized to an intervention group (neuromuscular electrical stimulation + conventional physical therapy) or a conventional group (sham neuromuscular electrical stimulation + conventional physical therapy). Primary outcome was thickness of the rectus abdominis and chest muscles, determined on cross-sectional ultrasound images before and after the intervention. RESULTS Eleven patients were included in the intervention group and 14 in the conventional group. After neuromuscular electrical stimulation, rectus abdominis muscle thickness and chest muscle thickness were preserved in the intervention group, whereas there was a significant reduction in thickness in the conventional group, with a significant difference between groups. There was a significant difference between groups in length of stay in the intensive care unit, with shorter length of stay in the intervention group. CONCLUSION There was no change in rectus abdominis and chest muscle thickness in the intervention group. A significant decrease was found in these measures in the conventional group.

Telerehabilitation for Cardiac Patients: Systematic Review

Mailing Address: Danieli de Cristo Rua Ludovico Della Mea, 685. Postal Code: 99040-170, Vera Cruz, Passo Fundo, RS Brazil. E-mail: danielidecristo@yahoo.com.br, danielidecristo2@gmail.com Telerehabilitation for Cardiac Patients: Systematic Review Danieli de Cristo,1 Natan Pinto do Nascimento,1 Alexandre Simões Dias,2 Amanda Sachetti1 Universidade de Passo Fundo (UPF),1 Rio Grande do Sul, RS Brazil Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul,2 Rio Grande do Sul, RS Brazil

Early ambulation using a cycle ergometer on quadriceps muscle morphology in mechanically ventilated critically ILL patients in the intensive care unit: a randomized controlled trial.

Patients in the intensive care unit (ICU) are exposed to prolonged immobility, which leads to loss of muscle mass. One resource that has proved to be of great utility in hospitals is the cycle ergometer, which is a stationary piece of equipment designed to enable cyclical rotations of lower and/or upper extremities and can be used to perform passive, active and resisted exercises.

Use of electrical neuromuscular stimulation to preserve the morphology of abdominal and chest muscles of critical patients: randomized clinical trial

Neuromuscular electrical stimulation (NMES) has been used as an early therapeutic modality at intensive care units (ICUs) to treat patients on invasive mechanical ventilation (IMV) to compensate and/or decrease loss of muscle mass.