RESUMO
OBJECTIVE: To address the current practice of liberating patients from invasive mechanical ventilation in pediatric intensive care units, with a focus on the use of standardized protocols, criteria, parameters, and indications for noninvasive respiratory support postextubation. METHODS: Electronic research was carried out from November 2021 to May 2022 in Ibero-American pediatric intensive care units. Physicians and respiratory therapists participated, with a single representative for each pediatric intensive care unit included. There were no interventions. RESULTS: The response rate was 48.9% (138/282), representing 10 Ibero-American countries. Written invasive mechanical ventilation liberation protocols were available in only 34.1% (47/138) of the pediatric intensive care units, and their use was associated with the presence of respiratory therapists (OR 3.85; 95%CI 1.79 - 8.33; p = 0.0008). The most common method of liberation involved a gradual reduction in ventilatory support plus a spontaneous breathing trial (47.1%). The mean spontaneous breathing trial duration was 60 - 120 minutes in 64.8% of the responses. The presence of a respiratory therapist in the pediatric intensive care unit was the only variable associated with the use of a spontaneous breathing trial as the primary method of liberation from invasive mechanical ventilation (OR 5.1; 95%CI 2.1 - 12.5). Noninvasive respiratory support protocols were not frequently used postextubation (40.4%). Nearly half of the respondents (43.5%) reported a preference for using bilevel positive airway pressure as the mode of noninvasive ventilation postextubation. CONCLUSION: A high proportion of Ibero-American pediatric intensive care units lack liberation protocols. Our study highlights substantial variability in extubation readiness practices, underscoring the need for standardization in this process. However, the presence of a respiratory therapist was associated with increased adherence to guidelines.
Assuntos
Unidades de Terapia Intensiva Pediátrica , Respiração Artificial , Desmame do Respirador , Humanos , América Latina , Criança , Inquéritos e Questionários , Ventilação não Invasiva , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricosRESUMO
Na tentativa de integrar a teoria da partilha social de emoções (PSE) com a conjugalidade, esse estudo avaliou o impacto da qualidade da PSE na satisfação conjugal e se há diferenças entre homens e mulheres nesse processo. Para isso, 185 participantes, de nacionalidade portuguesa, com idade igual ou superior a 30 anos, que estavam em relacionamento conjugal, responderam a um questionário sociodemográfico, à Escala de Avaliação da Satisfação em Áreas da Vida Conjugal (EASAVIC), à Differential Emotion Scale, a um conjunto de medidas e indicadores da PSE, a questões do Inquérito Social Europeu sobre bem-estar subjetivo e à versão reduzida da Escala de Apoio Social (Haslam et al., 2005). Os resultados obtidos relacionaram a qualidade da PSE à satisfação conjugal, sendo que maiores níveis na qualidade da PSE parecem estar relacionados a maiores níveis de satisfação conjugal. Ao contrário do esperado, homens e mulheres não demonstraram diferenças significativas em relação ao impacto da PSE na satisfação conjugal. Visto a possível influência da PSE nos níveis de satisfação conjugal, o estudo demonstrou a importância de serem conduzidas investigações relacionadas à qualidade da PSE nas relações conjugais.
In an attempt to integrate social sharing of emotions (SSE) theory with conjugality, this study evaluated the impact of SSE quality on marital satisfaction and whether if there is difference between men and women in this process. For this purpose, 185 participants, of Portuguese nationality, aged 30 years or more, who were in a marital relationship, answered a sociodemographic questionnaire, the Satisfaction Assessment Scale in Areas of Conjugal Life (EASAVIC), the Differential Emotion Scale, a set of measures and indicators related to SSE, an European Social Survey questions related to subjective well-being and a reduced version of the Social Support Scale (Haslam et al., 2005). The obtained results related SSE quality with marital satisfaction suggesting that higher levels of SSE quality seem to be related to higher levels of marital satisfaction. On the opposite of what was expected, men and women did not demonstrated significant differences. Considering the possible influence of SSE on the levels of marital satisfaction, this research supports the importance of being conduct researches related to the quality of SSE in marital relationships.