1 / 39

RESPOSTA METABÓLICA AO TRAUMA

RESPOSTA METABÓLICA AO TRAUMA. Prof. Wolnei Caumo Serviço de Dor e Medicina Paliativa do HCPA Departamento de Farmacologia - ICSB-UFRGS Departamento de Cirurgia - FAMED/UFRGS. EXISTEM EVIDÊNCIAS DE MEDIDAS TERAPÊUTICAS USADAS NO MANEJO DA RESPOSTA ENDÓCRINA AO TRAUMA?.

bozica
Télécharger la présentation

RESPOSTA METABÓLICA AO TRAUMA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. RESPOSTA METABÓLICA AO TRAUMA Prof. Wolnei Caumo Serviço de Dor e Medicina Paliativa do HCPA Departamento de Farmacologia - ICSB-UFRGS Departamento de Cirurgia - FAMED/UFRGS

  2. EXISTEM EVIDÊNCIAS DE MEDIDAS TERAPÊUTICAS USADAS NO MANEJO DA RESPOSTA ENDÓCRINA AO TRAUMA?

  3. Corticosteroids in the Treatment of Severe Sepsis and Septic Shock in Adults: A Systematic Review Djillali Annane; Eric Bellissant; Pierre-Edouard Bollaert; et al. JAMA. 2009;301(22):2362-2375 (doi:10.1001/jama.2009.815 Mortalidade em 28 d - (RR= 0.84 (IC 95%, 0.72-0.97) Reversão do choque RR= 1.12 (IC 95%; 1.02-1.23) Tempo médio de permanecia no CTI 4.49 d (IC 95%; –7.04 to –1.94) (RR, 0.84; 95% CI, 0.72- 0.97; P=.02).

  4. IMPACTO DE INTERVENÇÕES NA MORBI-MORTALIDADE Hypothermia for traumatic head injury. Efeito na mortalidade OR = 0.84 (IC 95%; 0.67 to 1.05) Cochrane Database Syst Rev. 2009 Apr 15;(2):CD001048. Sydenham E, Roberts I, Alderson P. Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials Mortalidade OR=1.6 (IC 95%, 0.3, 9.3, 3) Tempo de permanência no CTI (DMP) -3.7 d (IC 95% -11.4 a 4) Tempo de permanência hospitalar (DMP) -6.7 (IC 95% -19.8 a 6.4) Tempo de ventilação mecânica (DMP) -7.5 (IC 95%; -16.3 a 1.2) Tempo de ventilação mecânica (DMP) – BP torácico – analgesia com anestésico local (DMP) -4.2 (IC 95%; -5.5, -2.9) Can J Anaesth. 2009 Mar;56(3):230-42. Epub 2009 Feb 11. Carrier FM, Turgeon AF, Nicole PC, Trépanier CA, Fergusson DA, Thauvette D, Lessard MR.

  5. IMPACTO DE INTERVENÇÕES NA MORBI-MORTALIDADE Impact of fever on outcome in patients with stroke and neurologic injury: a comprehensive meta-analysis RR mortalidade 1.5 Aumento no escore da Escala de Glasgow Tempo de permanecia no CTI RR=2,8 Tempo de permanência hospitalar RR=3,2 Greer DM, Funk SE, Reaven NL, Ouzounelli M, Uman GC Stroke. 2008 Nov;39(11):3029-35. Epub 2008 Aug 21. . Corticosteroids in the Treatment of Severe Sepsis and Septic Shock in Adults: A Systematic Review Mortalidade em 28 d - (RR= 0.84 (IC 95%, 0.72-0.97) Reversão do choque RR= 1.12 (IC 95%; 1.02-1.23) Tempo médio de permanecia no CTI 4.49 d (IC 95%; –7.04 to –1.94) Djillali Annane; Eric Bellissant; Pierre-Edouard Bollaert; et al. JAMA. 2009;301(22):2362-2375 (doi:10.1001/jama.2009.815

  6. Towards Understanding Tight Glycemic Control in the ICU: A Systematic Review and Meta-analysis Mortalidade em 28 d - OR 0.95 (IC 95%; 0.87-1.05) - NPT Chest. 2009 Dec 16. [Epub ahead of print] Marik PE, Preiser JC. IMPACTO DE INTERVENÇÕES NA MORBI-MORTALIDADE A systematic review of heparin to treat burn injury Mortalidade 0.32 (IC 95%; 0.18-0.57) J Burn Care Res. 2007 Nov-Dec;28(6):794-804.. Oremus M, Hanson MD, Whitlock R, Young E, Archer C, Dal Cin A, Gupta A, Raina P.

  7. Immunonutrition in critically ill patients: a systematic review and analysis of the literature Arginina, arginina e glutamina, arginina e óleo de peixe Infecção OR 0.63 (IC 95%; 0.47-0.86) Nos que receberam óleo de peixe Mortalidade OR 0.42, 95% CI 0.26-0.68 e infecção (OR 0.42, 95% CI 0.26-0.68; OR 0.45 (IC 95%, 0.25-0.79) Tempo de permeância hospitalar -6.28 d (IC 95% -9.92 a -2.64) Intensive Care Med. 2008 Nov;34(11):1980-90. Epub 2008 Jul 15. Marik PE, Zaloga GP.

  8. Interventions for preventing critical illness polyneuropathy and critical illness myopathy NEUROPATIA/ MIOPATA - RR - 0.65 (CI 95%, 0.55 - 0.78) TEMPO DE VENTILAÇÃO MECÂNICA, TMEPO DE PERMANÂNCIA NO CTI, MORTALIDADE EM 180 DIAS Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006832.. Hermans G, De Jonghe B, Bruyninckx F, Van den Berghe G.

More Related