Navegando por Palavras-chave "Terapia respiratória"

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    Ensaio clínico, aberto, controlado sobre a adição de brometo de ipratrópio ao fenoterol no tratamento da crise de asma em adultos
    (Sociedade Brasileira de Pneumologia e Tisiologia, 1999-12-01) Diccini, Solange [UNIFESP]; Silva, Clystenes Odyr Soares [UNIFESP]; Nakatani, Jorge [UNIFESP]; Pereira, Carlos Alberto de Castro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Repeated dosis of inhaled b2-agonists have been used in the treatment of acute asthma. The effect of added ipratropium bromide (IB) to b2-agonist is controversial in adults. OBJECTIVE: To evaluate if addition of IB to fenoterol, in repeated doses, induces a greater bronchodilation, a greater reversion of the attack, and discharge from emergency unit in adults with acute severe asthma. SETTING: Pneumology Emergency Department, UNIFESP-Hospital São Paulo, in the period from July 1995 to February 1997. TYPE OF STUDY: Open, randomized and parallel study. Discharge from the hospital: FEV1 and PEF > 60% of the predicted value. METHODS: 120 patients with FEV1 and PEF < 50% of the predicted value were divided into two groups (N = 60): fenoterol (F) and ipratropium bromide + fenoterol (IBF). Each group received inhalation treatment through a metered-dose inhaler (MDI) attached to a holding chamber, administered at 30-minute interval, for a total of three treatments. In the group F four puffs of fenoterol (400 mg) were administered, and in the IBF group, 160 mg of BI and 400 mg of fenoterol (four puffs). RESULTS: The patients did not differ from basal PEF (F = 36 ± 7% vs IBF = 35 ± 9% predicted) and basal FEV1 (F = 33 ± 9% vs IBF = 32 ± 9% predicted). Thirty-two patients of group F and 33 of group IBF were discharged from hospital after the inhalation treatment. The final FEV1 and PEF after inhalation treatments were F = 60 ± 13% vs IBF = 61 ± 11% e F = 74 ± 18% vs IBF = 77 ± 13% (NS). CONCLUSION: The addition of ipratropium bromide to fenoterol results in insignificant functional effect and without clinical impact in the treatment of acute asthma in adults.
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    Impacto de um programa de educação continuada na qualidade assistencial oferecida pela fisioterapia em terapia intensiva
    (Associação de Medicina Intensiva Brasileira - AMIB, 2014-03-01) Pinto, Walkyria Araújo Macedo; Rossetti, Heloisa Baccaro; Araújo, Abigail; Spósito Júnior, José Jonas; Salomão, Hellen; Mattos, Simone Siqueira; Rabelo, Melina Vieira; Machado, Flávia Ribeiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective:To evaluate the role of quality indicators and adverse events registering in the quality assessment of intensive care physiotherapy and to evaluate the impact of implementing protocolized care and professional training in the quality improvement process. Methods:A prospective before-after study was designed to assess 15 indicators of the quality of care. Baseline compliance and adverse events were collected before and after the implementation of treatment protocols and staff training. Results:Eighty-nine patients admitted, being 48 in the pre-intervention period and 41 in the post-intervention period with a total of 1246 and 1191 observations respectively. Among the indicators related to the global population, there was a significant improvement in chest x-ray control, multidisciplinary rounds and shift changes as well as in compliance with these decisions. Indicators related to the population under mechanical ventilation, obtained by direct observation at bedside, showed a significant improvement in the compliance with the tidal volume of 6-8mL/Kg, plateau pressure <30cmH2O, adequate mechanical ventilation alarm setting, mechanical ventilation humidification control, adequate humidification line exchange and orotracheal tube position. Among the mechanical ventilation indicators collected through the physiotherapy records, there was significantly improved compliance with the predicted tidal volume registry and cuff pressure registry. There was a significant reduction in the number of adverse events. There was no impact on intensive care unit mortality, length of stay, duration of mechanical ventilation and ventilator-free days.Conclusion:It is possible to measure the quality of physiotherapy care using indicators of quality control. The implementation of care protocols and training of the professionals can improve team performance.