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Browsing by Author "Ratti, L"

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  • Inspiratory Muscle Training in the Intensive Care Unit: A New Perspective
    Publication . Tonella, R; Ratti, L; Delazari, L; Junior, C; Lima da Silva, P; Herran, A; dos Santos Faez, D; Saad, I; Castilho de Figueiredo, L; Moreno, R; Dragosvac, D; Falcao, A
    BACKGROUND: Prolonged use of mechanical ventilation (MV) leads to weakening of the respiratory muscles, especially in patients subjected to sedation, but this effect seems to be preventable or more quickly reversible using respiratory muscle training. The aims of the study were to assess variations in respiratory and hemodinamic parameters with electronic inspiratory muscle training (EIMT) in tracheostomized patients requiring MV and to compare these variations with those in a group of patients subjected to an intermittent nebulization program (INP). METHODS: This was a pilot, prospective, randomized study of tracheostomized patients requiring MV in one intensive care unit (ICU). Twenty-one patients were randomized: 11 into the INP group and 10 into the EIMT group. Two patients were excluded in experimental group because of hemodynamic instability. RESULTS: In the EIMT group, maximal inspiratory pressure (MIP) after training was significantly higher than that before (P = 0.017), there were no hemodynamic changes, and the total weaning time was shorter than in the INP group (P = 0.0192). CONCLUSION: The EIMT device is safe, promotes an increase in MIP, and leads to a shorter ventilator weaning time than that seen in patients treated using INP.
    2017-11Journal article Open access Show more
  • Transcutaneous Electrical Diaphragmatic Stimulation Reduces the Duration of Invasive Mechanical Ventilation in Patients with Cervical Spinal Cord Injury: Retrospective Case Series
    Publication . Duarte, G; Bethiol, A; Ratti, L; Franco, G; Moreno, R; Tonella, R; Falcão, AL
    Study design: Retrospective case series. Objectives: To compare individuals with cervical spinal cord injury (SCI) submitted to transcutaneous electrical diaphragmatic stimulation (TEDS) or a standard weaning protocol (SWP) according to the following variables: invasive mechanical ventilation (IMV) time, ventilator weaning time, intensive care unit (ICU) length of stay, and overall hospital length of stay. Settings: Tertiary university hospital. Clinical Hospital of Campinas State University-UNICAMP-Campinas (SP), Brazil. Methods: Retrospective case study investigating ICU patients submitted to tracheostomy due to cervical SCI at a tertiary university hospital (Clinical Hospital of Campinas State University, Brazil). Data were extracted from medical records of patients seen between January 2007 and December 2016. According to medical records, four patients were submitted to TEDS and six to a SWP. Provision of training to patients in the TEDS group was based on consensus medical decision, preference of the physical therapy team and availability of electrostimulation equipment in the ICU. Results: Total IMV time in the TEDS and the SWP group was 33 ± 15 and 60 ± 22 days, respectively. Length of stay in ICU in the TEDS and the SWP group was 31 ± 18 and 63 ± 45 days, respectively. Conclusion: TEDS appears to influence the duration of IMV as well as the length of stay in ICU. This physiotherapeutic intervention may be a potentially promising tool for treatment of patients with SCI. However, randomized clinical trials are warranted to support this assumption.
    2021Journal article Open access Show more