Simone Chaves Fagondes, Carmem Lúcia Oliveira da Silva, Anneliese Hoffmann, Rita de Cássia Guedes de Azevedo Barbosa, Daiane Falkembach, Ângela Beatriz John
{"title":"Home mechanical ventilation: a narrative review and a proposal of practical approach.","authors":"Simone Chaves Fagondes, Carmem Lúcia Oliveira da Silva, Anneliese Hoffmann, Rita de Cássia Guedes de Azevedo Barbosa, Daiane Falkembach, Ângela Beatriz John","doi":"10.1016/j.bjane.2025.844595","DOIUrl":"https://doi.org/10.1016/j.bjane.2025.844595","url":null,"abstract":"<p><p>Growing evidence of the benefits of home ventilatory support in patients with chronic respiratory failure along with technological advances in ventilators have enabled their use in overly complex situations, shaping a new scenario for physicians. This has further given rise to new challenges related to their incorporation into current medical practice. However, this evolution needs to be coupled with knowledge and skills of physicians who are willing to prescribe Home Mechanical Ventilation (HMV), in order to prevent them from making inappropriate choices or adjustments that may ultimately have ethical and legal implications. This article aims to provide guidance and information to support the indication for HMV and the ventilation modalities to be implemented, review basic ventilation concepts, including the ventilator modes most commonly used in patients outside the hospital setting, list the brands and models available in the Brazilian market, provide the means for obtaining equipment for HMV, and finally, describe the requirements for selection of equipment, taking into account the individual characteristics of the patient to ensure safe perioperative care and earlier dehospitalization.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844595"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghada Mohammad Abo Elfadl, Abdelraheem Mahmoud Elawamy, Abualauon Mohamed Abedalmohsen, Azza Abo Elfadl El Sayed, Mustafa Bahloul, Eman Ahmed Ismail
{"title":"Prophylactic use of platelet-rich plasma for post-spinal low back pain following gynecological surgery: a randomized clinical trial.","authors":"Ghada Mohammad Abo Elfadl, Abdelraheem Mahmoud Elawamy, Abualauon Mohamed Abedalmohsen, Azza Abo Elfadl El Sayed, Mustafa Bahloul, Eman Ahmed Ismail","doi":"10.1016/j.bjane.2021.09.009","DOIUrl":"10.1016/j.bjane.2021.09.009","url":null,"abstract":"<p><strong>Background: </strong>Post-spinal back pain is suggested to occur as a result of a localized inflammatory response that is often associated with some degree of muscle spasm. We aimed to evaluate the effect of platelet-rich plasma (PRP) in reducing the incidence of post-spinal back pain.</p><p><strong>Methods: </strong>One hundred patients were randomly enrolled and scheduled for elective gynecological surgery under spinal anesthesia. After the subarachnoid block, group A (placebo) received 2 mL of sodium chloride 0.9% injected into the track of spinal needle during its withdrawal (2 mm after outward withdrawal in muscles and subcutaneous tissues). While patients in group B (PRP); received 2 ml of PRP injected into the track of the spinal needle during its withdrawal. The primary outcome was the number of patients who developed post-spinal low back pain within the first week following the subarachnoid block. Secondary outcomes included the time of the first analgesic request and total meperidine consumption during the first 24 h postoperatively.</p><p><strong>Results: </strong>Fifteen patients in the PRP group developed low back pain during the first week following subarachnoid block compared to 26 patients in the placebo group (p = 0.037). There was a significant decrease in the mean meperidine consumption during first 24 h postoperatively in PRP group (174 ± 14 mg) compared to placebo group (210 ± 22 mg) (p < 0.0001). Also, the first analgesic request was significantly delayed in PRP group (243 ± 21 min.) compared to placebo group (185 ± 31 min.) (p < 0.0001).</p><p><strong>Conclusion: </strong>This study demonstrated the positive effects of platelet-rich plasma on the prevention of post-spinal backache.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39500474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghada Mohammad Abo Elfadl, Ayman Mamdouh Osman, Mina Fayez Ghalyoom, Nawal Abdel-Aziz Gad Al-Rab, Mustafa Bahloul
{"title":"WITHDRAWN: Preoperative duloxetine to prevent postoperative shoulder pain after gynecologic laparoscopy: a randomized controlled trial.","authors":"Ghada Mohammad Abo Elfadl, Ayman Mamdouh Osman, Mina Fayez Ghalyoom, Nawal Abdel-Aziz Gad Al-Rab, Mustafa Bahloul","doi":"10.1016/j.bjane.2021.07.035","DOIUrl":"10.1016/j.bjane.2021.07.035","url":null,"abstract":"<p><p>This article has been withdrawn at the request of the editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10773488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sérgio Timerman, Hélio Penna Guimarães, Roseny Dos Reis Rodrigues, Thiago Domingos Corrêa, Daniel Ujakow Correa Schubert, Ana Paula Freitas, Álvaro Rea Neto, Thatiane Facholi Polastri, Matheus Fachini Vane, Thomaz Bittencourt Couto, Antonio Carlos Aguiar Brandão, Natali Schiavo Giannetti, Maria José Carvalho Carmona, Thiago Timerman, Ludhmila Abrahão Hajjar, Fernando Bacal, Marcelo Queiroga
{"title":"Recommendations for Cardiopulmonary Resuscitation (CPR) of patients with suspected or confirmed COVID-19.","authors":"Sérgio Timerman, Hélio Penna Guimarães, Roseny Dos Reis Rodrigues, Thiago Domingos Corrêa, Daniel Ujakow Correa Schubert, Ana Paula Freitas, Álvaro Rea Neto, Thatiane Facholi Polastri, Matheus Fachini Vane, Thomaz Bittencourt Couto, Antonio Carlos Aguiar Brandão, Natali Schiavo Giannetti, Maria José Carvalho Carmona, Thiago Timerman, Ludhmila Abrahão Hajjar, Fernando Bacal, Marcelo Queiroga","doi":"10.1016/j.bjane.2020.06.007","DOIUrl":"10.1016/j.bjane.2020.06.007","url":null,"abstract":"<p><p>The care for patients suffering from cardiopulmonary arrest in a context of a COVID-19 pandemic has particularities that should be highlighted. The following recommendations from the Brazilian Association of Emergency Medicine (ABRAMEDE), the Brazilian Society of Cardiology (SBC) and the Brazilian Association of Intensive Medicine (AMIB) and the Brazilian Society of Anesthesiology (SBA), associations and societies official representatives of specialties affiliated to the Brazilian Medical Association (AMB), aim to guide the various assistant teams, in a context of little solid evidence, maximizing the protection of teams and patients. It is essential to wear full Personal Protective Equipment (PPE) for aerosols during the care of Cardiopulmonary Resuscitation (CPR) and it is imperative to consider and treat the potential causes in these patients, especially hypoxia and arrhythmias caused by changes in the QT interval or myocarditis. The installation of an advanced invasive airway must be obtained early and the use of High Efficiency Particulate Arrestance (HEPA) filters at the interface with the valve bag is mandatory; situations of occurrence of CPR during mechanical ventilation and in a prone position demand peculiarities that are different from the conventional CPR pattern. Faced with the care of a patient diagnosed or suspected of COVID-19, the care follows the national and international protocols and guidelines 2015 ILCOR (International Alliance of Resuscitation Committees), AHA 2019 Guidelines (American Heart Association) and the Update of the Cardiopulmonary Resuscitation and Emergency Care Directive of the Brazilian Society of Cardiology 2019.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38302110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mário Humberto Curado Taveira, Antonio Fernando Carneiro, Gustavo Gabriel Rassi, Marise Amaral Rebouças Moreira, Simone de Andrade Curado Taveira
{"title":"There is high incidence of skin cells in the first and third drops of cerebrospinal fluid in spinal anesthesia.","authors":"Mário Humberto Curado Taveira, Antonio Fernando Carneiro, Gustavo Gabriel Rassi, Marise Amaral Rebouças Moreira, Simone de Andrade Curado Taveira","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and objectives: </strong>Skin fragments during lumbar punctures may develop intraspinal epidermoid tumors. The aim of this study was to determine the incidence of epithelial cells that reflow along with the fi rst and third drops of CSF of patients undergoing spinal anesthesia.</p><p><strong>Methods: </strong>Samples of the fi rst and third drops of cerebrospinal fluid were collected from 39 adult patients undergoing spinal anesthesia with a 25G Quincke needle. Four microscope slides were prepared: one for the fi rst drop, one for third drop, one for the needle, and one with a drop of saline for control. A pathologist examined the slides randomly.</p><p><strong>Results: </strong>Squamous epithelial cells were identified in 35 (89.7%) samples from the fi rst drop, 34 (87.2%) from the third drop, and 24 (61.5%) from spinal needle. The third drop showed a mean number of cells larger than the fi rst drop (p = 0.046). Nucleated epithelial cells were found in a sample of the fi rst drop (2.56%), in four samples of third drop (10.25%), and in one spinal needle (2.56%). Third drop showed a mean number of nucleated cells higher than fi rst drop with no statistical difference (p = 0.257).</p><p><strong>Conclusions: </strong>High percentage of epithelial cells was found in the fi rst (89.7%) and third (87.2%) drops of CSF reflow and in used needles (61.5%). Skin cells were found even using small gauge disposable needles with well-adapted mandrel.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":"63 2","pages":"193-6"},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32237017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}