Navegando por Palavras-chave "Fluid Therapy"

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    Consumo alimentar e condições de trabalho no corte manual de cana de açúcar no estado de São Paulo1
    (Faculdade de Saúde Pública, Universidade de São Paulo.Associação Paulista de Saúde Pública., 2014-12-01) Luz, Verônica Gronau; Zangirolani, Lia Thieme Oikawa [UNIFESP]; Vilela, Rodolfo Andrade de Gouveia; Corrêa Filho, Heleno Rodrigues; Universidade Federal de Alfenas; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Universidade Estadual de Campinas (UNICAMP)
    ObjectiveTo describe the working conditions and aspects related with food consumption amongst manual workers in sugar-cane crops intending to contribute to developing public policies towards workers’ health surveillance and delivering comprehensive services. MethodDirect observation at the work field in upstate São Paulo and a semi-structured questionnaire were conducted with a group of forty sugar-cane migrant workers who came from Ceará state to work as hand harvesters in São Paulo state, over 15 days during the 2007/2008 crop season. Socio-demographic data, water consumption, food consumption and cultural habits, hydro-electrolyte reposition, work pauses, body pains and duration of working days were registered. ResultWorkers ingested 5 to 10 liters of water/day and the dilution of electrolytes replacement was below the adequate recommendations. Food consumptions during the crop season did not ensure food and nutritional security. Food consumption was monotonous, conserved and consumed at inadequate temperature, and incompatible with cultural habits, implying reduction and wastage of food. Workers reported pains and cramps during the work day. Pauses for resting were insufficient. Payment by results, the working process and payment practices were taken as determinants of a wide range of precarious conditions to which these workers were subjected. The hand harvesting of sugar-cane is extenuating and the payment by results may be a grievance for health as it implies reducing the work resting pauses. Food consumption and adequate hydration could minimize the working wear and pains during the job.
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    Variações Da Pressão Venosa Central Durante A Prova De Volume Têm Valor Limitado Para Guiar A Infusão De Fluidos
    (Universidade Federal de São Paulo (UNIFESP), 2018-10-25) Oliveira, Priscilla Souza De [UNIFESP]; Machado, Flavia Ribeiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: Static values of central venous pressure (CVP) have limitations to guide fluid management although dynamic changes are considered useful. We evaluated if changes in CVP and the baseline cyclic variation in the amplitude of CVP curve (ΔCVP) could discriminate responders from non-responders. Design: Prospective, observational study. Setting: Two mixed intensive care. Patients: Adult patients under mechanical ventilation with acute circulatory failure who received a fluid challenge with crystalloids (Ringer's lactate or sodium chloride 0.9% solution, 500 mL infused over 15 minutes). Measurements and Main Results: We determined the CVP at baseline (CVPT0), its amplitude during respiratory cycle (ΔCVP) and the changes at 5 (ΔCVPT5), 10 (ΔCVPT10) and 15 (ΔCVPT15) minutes during fluid infusion. Fluid responsiveness was defined by a cardiac index increased ≥ 15%. We included 30 patients. There was a significant increase over time in CVP for both groups (0.12 mmHg, SE: 1.36 mmHg, p-value: < 0.001) although with no significant differences in CVP changes between responder and non-responders over time (-0.03 mmHg, SE: 0.03 mmHg, p-value:0.253) and for CVP between groups (-2.73 mmHg, SE: 1.36, p-value = 0.055). The cardiac index did not correlate with the changes in CVP after the fluid challenge (R=-0.25, p value = 0.182). The CVPT0 and the changes after fluid challenge in all three timepoints did not adequately predict fluid responsiveness (CVPT0 - AUC: 0.696 (95%CI: 0.492 - 0.901), ΔCVPT5 - AUC: 0.780 (95%CI:0.572 - 0.988), ΔCVPT10 - AUC: 0.634 (95%CI:0.385 - 0.883), ΔCVPT15 - AUC: 0.684 ((95%CI: 0.453 - 0.915)). The ΔCVP at baseline also had poor performance (AUC: 0.703 (95%CI: 0.500 - 0.907). Conclusions: Dynamic changes in CVP have limited value to guide fluid management. Changes in CVP after fluid infusion and ΔCVP at baseline cannot be used as a marker of fluid responsiveness in patients under mechanical ventilation.