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1.
Med Intensiva ; 36(4): 294-306, 2012 May.
Artigo em Espanhol | MEDLINE | ID: mdl-22014424

RESUMO

Mechanical ventilation is a therapeutic intervention involving the temporary replacement of ventilatory function with the purpose of improving symptoms in patients with acute respiratory failure. Technological advances have facilitated the development of sophisticated ventilators for viewing and recording the respiratory waveforms, which are a valuable source of information for the clinician. The correct interpretation of these curves is crucial for the correct diagnosis and early detection of anomalies, and for understanding physiological aspects related to mechanical ventilation and patient-ventilator interaction. The present study offers a guide for the interpretation of the airway pressure and flow and volume curves of the ventilator, through the analysis of different clinical scenarios.


Assuntos
Respiração Artificial , Insuficiência Respiratória/fisiopatologia , Insuficiência Respiratória/terapia , Doença Aguda , Humanos , Respiração
2.
Med Intensiva ; 34(1): 46-55, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-19811855

RESUMO

The Health System is in crisis and critical care (from transport systems to the ICU) cannot escape from that. Lack of integration between ambulances and reference Hospitals, a deep shortage of critical care specialists and assigned economical resources that increase less than critical care demand are the cornerstones of the problem. Moreover, the analysis of the situation anticipated that the problem will be worse in the future. "Closed" ICUs in which critical care specialists direct patient care outperform "open" ones in which primary admitting physicians direct patient care in consultation with critical care specialists. However, the current paradigm in which a critical care specialist is close to the patient is in the edge of the trouble so, only a new paradigm could help to increase the number of patients under intensivist care. Current information technology and networking capabilities should be fully exploited to improve both the extent and quality of intensivist coverage. Far to be a replacement of the existing model Telemedicine might be a complimentary tool. In fact, to centralize medical data into servers has many additional advantages that could even improve the way in which critical care physicians take care of their patients under the traditional system.


Assuntos
Cuidados Críticos/métodos , Serviços Médicos de Emergência/métodos , Medicina de Emergência/métodos , Unidades de Terapia Intensiva/organização & administração , Garantia da Qualidade dos Cuidados de Saúde , Telemedicina , Alarmes Clínicos , Redes de Comunicação de Computadores/organização & administração , Instrução por Computador , Custos e Análise de Custo , Cuidados Críticos/economia , Serviços Médicos de Emergência/economia , Medicina de Emergência/economia , Medicina de Emergência/educação , Previsões , Necessidades e Demandas de Serviços de Saúde , Sistemas de Comunicação no Hospital/organização & administração , Humanos , Unidades de Terapia Intensiva/economia , Monitorização Fisiológica/economia , Monitorização Fisiológica/instrumentação , Controle de Qualidade , Espanha , Telemedicina/economia , Telemedicina/organização & administração , Telemedicina/tendências , Recursos Humanos
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