Navegando por Palavras-chave "cardiopulmonary resuscitation"
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- ItemSomente MetadadadosAn avoidable tragedy: neonatal deaths associated to perinatal asphyxia(Soc Iberoamericana Informacion Cientifica-s I I C, 2008-04-01) Guinsburg, Ruth [UNIFESP]; Branco de Almeida, Maria Fernanda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Early neonatal mortality is an indicator of human development around the world. Asphyxia contributes to about 20-25% of these early deaths. In order to reduce early neonatal mortality rates, effective efforts should be directed to decrease social inequities by improving the access of pregnant women to health services, including appropriate care during the pre-natal period, labor and delivery. The newborn infants should be assisted by professionals skilled in recognizing the need for life support procedures and in executing them.
- ItemSomente MetadadadosCharacterization of cardiac arrest in the emergency department of a Brazilian University Reference Hospital: A prospective study(Medknow Publications & Media Pvt Ltd, 2016) Vancini-Campanharo, Cassia Regina [UNIFESP]; Vancini, Rodrigo Luiz; Barbosa de Lira, Claudio Andre; Andrade, Marlia dos Santos [UNIFESP]; Lopes, Maria Carolina Barbosa Teixeira [UNIFESP]; Okuno, Meiry Fernanda Pinto [UNIFESP]; Batista, Ruth Ester Assayag [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]; Gois, Aecio Flavio Teixeira de [UNIFESP]Background & objectives: Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality. Methods: This prospective study was conducted at Emergency Department of Sao Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3 +/- 17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality. Results: Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation. Interpretation & conclusions: The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.
- ItemAcesso aberto (Open Access)Family presence during cardiopulmonary resuscitation and invasive procedures in children(Sociedade de Pediatria de São Paulo, 2014-03-01) Ferreira, Cristiana Araujo G.; Balbino, Flávia Simphronio [UNIFESP]; Balieiro, Maria Magda Ferreira Gomes [UNIFESP]; Pettengill, Myriam Aparecida Mandetta [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective:To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units.Data sources : Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords family, invasive procedures, cardiopulmonary resuscitation, health staff, and Pediatrics. Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed.Data synthesis : Most articles were published in the United States (80%), in Medicine and Nursing (46%), and were surveys (72%) with healthcare team members (67%) as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a) to develop a sensitizing program for healthcare team; b) to educate the healthcare team to include the family in these circumstances; c) to develop a written institutional policy; d) to ensure the attendance of family's needs.Conclusions:Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes.
- ItemAcesso aberto (Open Access)Fatores que afetam a ventilação com o reanimador manual autoinflável: uma revisão sistemática(Sociedade de Pediatria de São Paulo, 2011-12-01) Oliveira, Pricila Mara Novais de [UNIFESP]; Almeida-Junior, Armando Augusto; Almeida, Celize Cruz Bresciani; Ribeiro, Maria Ângela Gonçalves de Oliveira; Ribeiro, José Dirceu; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: The manual resuscitator (RM) is a device that provides positive pressure ventilation. Surveys conducted to assess the adequacy of manual resuscitators to American Society for Testing and Materials standards show that several factors affect manual ventilation. However, results are conflicting. The aim of this study was to verify evidence of factors that influence pediatric/adult pulmonary ventilation with manual resuscitator by a systematic review. DATA SOURCE: Original articles indexed in Medline, Lilacs and SciELO published from January 1986 to March 2011. The key-words used were: manual resuscitator, manual ventilation, positive pressure ventilation in Portuguese and English, as well as bag-valve. DATA SYNTHESIS: 45 articles were selected, most of them experimental. The studies compared manual resuscitator brands and models, and analyzed the physical characteristics of professionals. The effectiveness of ventilation with manual resuscitator depends on the brand, model and functional characteristics of the equipment. Ventilation also varies with the education, training and experience of the professional who handles the equipment. Other factors that can influence effectiveness are the manual resuscitator compression form, the use of a pressure relief valve and the flow of oxygen provided to the manual resuscitator. CONCLUSIONS: The variability of ventilatory parameters during manual resuscitation does not allow a standardization of the technique, being harmful to cardiopulmonary resuscitation. Although most manual resuscitator seem to follow international standards, the equipment must be evaluated in the clinical settings. There are few studies about pediatric and neonatal manual resuscitator models.
- ItemSomente MetadadadosProactive management of extreme prematurity: disagreement between obstetricians and neonatologists(Nature Publishing Group, 2012-12-01) Guinsburg, Ruth [UNIFESP]; Branco de Almeida, M. F. [UNIFESP]; Santos Rodrigues Sadeck, L. dos; Marba, S. T. M.; Suppo de Souza Rugolo, L. M.; Luz, J. H.; Andrade Lopes, J. M. de; Martinez, F. E.; Procianoy, R. S.; Brazilian Network Neonatal Res; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Universidade Estadual de Campinas (UNICAMP); Pontificia Univ Catolica Rio Grande do Sul; Fundaco Oswaldo Cruz; Univ Fed Rio Grande do SulObjective: To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death.Study Design: Prospective cohort of 484 infants with 23(0/7) to 26(6/7) weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of >= 1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life.Result: Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions.Conclusion: in infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day. Journal of Perinatology (2012) 32, 913-919; doi:10.1038/jp.2012.28; published online 29 March 2012
- ItemSomente MetadadadosResuscitative procedures at birth in late preterm infants(Nature Publishing Group, 2007-12-01) Almeida, Maria Fernanda Branco de [UNIFESP]; Guinsburg, Ruth [UNIFESP]; Costa, J. O. da; Anchieta, L. M.; Freire, L. M. S.; Campos, D.; Universidade Federal de São Paulo (UNIFESP); Med Sch Barbacena; Universidade Federal de Minas Gerais (UFMG); Universidade de Brasília (UnB)Objective: Evaluate the need for resuscitative procedures at birth, in late prematures.Study Design: This prospective cohort study enrolled all liveborn infants from 1 to 30 September 2003, with 34 to 41 weeks of gestation without congenital anomalies, born in 35 public hospitals of 20 Brazilian state capitals. Logistic regression analyzed variables associated with the need for bag and mask ventilation.Result: of the 10 774 infants studied, 1054 were late preterms and 485 required resuscitative measures. of the 1054, 338 ( 32%) received only free-flow oxygen, 143 ( 14%) were bag and mask ventilated, 27 ( 3%) were intubated and 10/27 received chest compressions and/or medications. Bag and mask ventilation in late preterms was associated with twin gestation, maternal hypertension, nonvertex presentation, cesarean delivery and lower gestational age.Conclusion: Improving control of maternal hypertension, prolonging gestation for 1 to 2 weeks and restricting operative deliveries could decrease the need of resuscitation of late preterms at birth.