BRUNO ADLER MACCAGNAN PINHEIRO BESEN
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Flexible Versus Restrictive Visiting Policies in ICUs: A Systematic Review and Meta-Analysis*(2018) NASSAR JUNIOR, Antonio Paulo; BESEN, Bruno Adler Maccagnan Pinheiro; ROBINSON, Caroline Cabral; FALAVIGNA, Maicon; TEIXEIRA, Cassiano; ROSA, Regis GoulartObjectives:To synthesize data on outcomes related to patients, family members, and ICU professionals by comparing flexible versus restrictive visiting policies in ICUs. Data Sources:Medline, Scopus, and Web of Science. Study Selection:Observational and randomized studies comparing flexible versus restrictive visiting policies in the ICU and evaluating at least one patient-, family member-, or ICU staff-related outcome. Data Extraction:Duplicate independent review and data abstraction. Data Synthesis:Of 16 studies identified for inclusion, seven were meta-analyzed. Most studies were rated as having a moderate risk of bias. Among patients, flexible visiting policies were associated with reduced frequency of delirium (odds ratio, 0.39; 95% CI, 0.22-0.69; I-2 = 0%) and lower severity of anxiety symptoms (mean difference, -2.20; 95% CI, -3.80 to -0.61; I-2 = 71%). Flexible visiting policies were not associated with increased risk of ICU mortality (odds ratio, 0.71; 95% CI, 0.38-1.36; I-2 = 86%), ICU-acquired infections (odds ratio, 0.98; 95% CI, 0.68-1.42; I-2 = 11%), or longer ICU stay (mean difference, -0.26 d; 95% CI, -0.57 to 0.05; I-2 = 54%). Among family members, flexible visiting policies were associated with greater satisfaction. Among ICU professionals, flexible visiting policies were associated with higher burnout levels. Conclusions:Flexible ICU visiting hours have the potential to reduce delirium and anxiety symptoms among patients and to improve family members' satisfaction. However, they may be associated with an increased risk of burnout among ICU professionals. These conclusions are based on few studies, with small samples and moderate risk of bias.
- Methodological Reasons for the Association Between Hypocalcemia and Worse Outcomes in Intracranial Hemorrhage(2018) BESEN, Bruno Adler Maccagnan Pinheiro; ROEPKE, Roberta Muriel Longo
- Can We Discuss About RRT Starting Time Before We Have a Recovery BiomarkerYes, We Can(2018) BESEN, Bruno Adler Maccagnan Pinheiro; ROMANO, Thiago Gomes; PARK, Marcelo
- Caracterização de pacientes transportados com suporte respiratório e/ou cardiovascular extracorpóreo no Estado de São Paulo − Brasil(2018) LI, Ho Yeh; MENDES, Pedro Vitale; MELRO, Livia Maria Garcia; JOELSONS, Daniel; BESEN, Bruno Adler Maccagnan Pinheiro; COSTA, Eduardo Leite Viera; HIROTA, Adriana Sayuri; BARBOSA, Edzangela Vasconcelos Santos; FORONDA, Flavia Krepel; AZEVEDO, Luciano Cesar Pontes; ROMANO, Thiago Gomes; PARK, MarceloABSTRACT Objective: To characterize the transport of severely ill patients with extracorporeal respiratory or cardiovascular support. Methods: A series of 18 patients in the state of São Paulo, Brazil is described. All patients were consecutively evaluated by a multidisciplinary team at the hospital of origin. The patients were rescued, and extracorporeal membrane oxygenation support was provided on site. The patients were then transported to referral hospitals for extracorporeal membrane oxygenation support. Data were retrieved from a prospectively collected database. Results: From 2011 to 2017, 18 patients aged 29 (25 - 31) years with a SAPS 3 of 84 (68 - 92) and main primary diagnosis of leptospirosis and influenza A (H1N1) virus were transported to three referral hospitals in São Paulo. A median distance of 39 (15 - 82) km was traveled on each rescue mission during a period of 360 (308 - 431) min. A median of one (0 - 2) nurse, three (2 - 3) physicians, and one (0 - 1) physical therapist was present per rescue. Seventeen rescues were made by ambulance, and one rescue was made by helicopter. The observed complications were interruption in the energy supply to the pump in two cases (11%) and oxygen saturation < 70% in two cases. Thirteen patients (72%) survived and were discharged from the hospital. Among the nonsurvivors, there were two cases of brain death, two cases of multiple organ dysfunction syndrome, and one case of irreversible pulmonary fibrosis. Conclusions: Transportation with extracorporeal support occurred without serious complications, and the hospital survival rate was high.