Abstract
Strokes are the leading cause of death in Brazil, with an incidence of 108/100,000 inhabitants [1], 31% lethality, and beyond they are causes of disability and high social costs. The National Institute of Neurological Disorders and Stroke study (NINDS) [2] and the 3rd European Cooperative Acute Stroke Study [3] demonstrated that intravenous tissue plasminogen activator (t-PA) improved clinical outcome at 3 months. This study recognized the patient's profile attending a pioneer public Stroke Team - trained at Albert Einstein and Mae de Deus Hospitals - comparing and analyzing its results with NINDS.
Highlights
Noninvasive ventilation is a safe and effective method to treat acute respiratory failure, minimizing the respiratory workload and oxygenation
Many interventions are known to decrease the incidence of ventilator-associated pneumonia, which has great impact on mortality, length of stay and costs in intensive care units
One of them is the aspiration of the secretions that pool above the cuff of the endotracheal tube [1]
Summary
Noninvasive ventilation is a safe and effective method to treat acute respiratory failure, minimizing the respiratory workload and oxygenation. Previous studies have indicated risk factors for ICU readmission; sepsis, respiratory insufficiency, medical admission, organ dysfunctions and age are associated with this outcome. Logistic regression analysis showed that need for mechanical ventilation (odds ratio = 7.76; 95% CI = 4.56 to 12.85), presence of metastasis (odds ratio = 2.87; 95% CI = 2.06 to 5.28), occurrence of acute renal failure (odds ratio = 2.92; 95% CI = 1.67 to 9.46) and higher SOFA scores 72 hours after admission (odds ratio = 6.76; 95% CI = 5.56 to 13.85) were independently associated with increased hospital mortality. Conclusion This prospective analysis of 3,400 patients with cancer needing intensive care shows high survival rates and good quality of life after ICU admission These data encourage intensive care treatment in oncologic patients to prevent, detect and cure organ dysfunction. Adult critically ill patients need invasive mechanical ventilation support due to distinct causes that vary from an elective highrisk surgery to post cardiorespiratory arrest
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