Original Article

Impact of the implementation of a therapeutic guideline on the treatment of nosocomial pneumonia acquired in the intensive care unit of a university hospital

Impacto da implantação de um guia terapêutico para o tratamento de pneumonia nosocomial adquirida na unidade de terapia intensiva em hospital universitário

Joseani Coelho Pascual Garcia, Olavo Franco Ferreira Filho, Cíntia Magalhães Carvalho Grion, Claudia Maria Dantas de Maio Carrilho

J Bras Pneumol.2007;33(2):175-184

Incidence of acute lung injury and acute respiratory distress syndrome in the intensive care unit of a university hospital: a prospective study

Incidência de lesão pulmonar aguda e síndrome da angústia respiratória aguda no centro de tratamento intensivo de um hospital universitário: um estudo prospectivo

Raquel Hermes Rosa Oliveira, Aníbal Basille Filho

J Bras Pneumol.2006;32(1):35-42

Percutaneous Tracheostomy in Critically-ill Patients: The Experience of a Medical Intensive Care Unit

Traqueostomia percutânea no doente crítico: a experiência de uma unidade de terapia intensiva clínica

Marcelo Park, Leonardo Brauer, Ricardo Reis Sanga, André Carlos Kajdacsy-Balla Amaral, José Paulo Ladeira, Luciano Cesar Pontes de Azevedo, Leandro Utino Taniguchi, Luiz Monteiro da Cruz-Neto

J Bras Pneumol.2004;30(3):237-242

Role of the open lung biopsy in the evaluation of undiagnosed acute lung disease in a pediatric intensive care unit

Contribuição da biópsia pulmonar a céu aberto na avaliação de pneumopatias difusas e agudas em unidade de terapia intensiva pediátrica

Albert Bousso, Evandro Roberto Baldacci, José Carlos Fernandes, Iracema de Cássia Oliveira Fernandes, Andréa Maria Gomes Cordeiro, José Pinhata Otoch, Bernardo Ejzenberg, Yassuhiko Okay

J Bras Pneumol.2002;28(1):30-40

Introduction: The diagnosis of diffuse lung disease is still a challenge for the pediatric intensive care physician. Routine clinical examinations and laboratory tests are frequently negative. The objective of this study was to evaluate the diagnostic potential, the impact on therapy and the rate of complications of open lung biopsy in children with undiagnosed diffuse lung disease, respiratory failure and inappropriate response to initial therapy. Methods: From January 1987 to January 1997, 29 children with diffuse pulmonary disease of unknown etiology, respiratory failure (PaO2 /FiO2 < 300) and no response to previous treatments were considered for open lung biopsy. Newborns, children with known chronic pulmonary disease and children with untreatable shock or coagulopathy were excluded. All biopsies were performed by a thoracic surgeon by a microthoracotomy in the lung shown to be the most affected by X-ray examination. Tissue samples were analyzed in terms of cultures, light microscopy, electron microscopy and immunofluorescence microscopy, according to the pathologist's decision. Results: All biopsies (100%) resulted in at least one histological diagnosis and in 20 patients (68.9%) it was obtained a specific diagnosis. The most frequent histological patterns found were: non-specific interstitial pneumonitis with variable degrees of fibrosis in 18 cases; bronchiolitis in eight cases and pulmonary hypertension in three cases. Regarding the most frequent specific diagnosis, six children were found with cytomegalovirus infection, three with Pneumocystis carinii, three with adenovirus and three with respiratory syncytial virus infection. These data induced a change in therapy in 20 children (68.9%). The most frequent changes in therapy were the use of corticosteroids in 14 children and a review of the antibiotic regimen in six patients. Seven patients (24.1%) presented with complications that were easily resolved. There were 13 deaths, probably due to the critical conditions of these patients, all unrelated to the procedure. Conclusions: Open lung biopsy, though an invasive procedure, should be considered in the evaluation of selected children with undiagnosed diffuse lung disease, respiratory failure and with no satisfactory response to previous therapies.

Review Article

Nosocomial pneumonia: importance of the oral environment

Pneumonia nosocomial: importância do microambiente oral

Simone Macedo Amaral, Antonieta de Queiróz Cortês, Fábio Ramôa Pires

J Bras Pneumol.2009;35(11):1116-1124

Sleep in the intensive care unit

Sono na unidade de terapia intensiva

Flávia Gabe Beltrami1, Xuân-Lan Nguyen2, Claire Pichereau3, Eric Maury3, Bernard Fleury4, Simone Fagondes1,5

J Bras Pneumol.2015;41(6):539-546

Original Article

Prevalence of ventilator-associated pneumonia in a university hospital and prognosis for the patients affected

Prevalência e prognóstico dos pacientes com pneumonia associada à ventilação mecânica em um hospital universitário

Márcio Martins de Queiroz Guimarães, José Rodolfo Rocco

J Bras Pneumol.2006;32(4):339-346

Objective: To determine the prevalence of ventilator-associated pneumonia in an intensive care unit, as well as to identify related factors and characterize patient evolution. Methods: This study evaluated 278 patients on mechanical ventilation for more than 24 hours in a university hospital. Results: Ventilator-associated pneumonia developed in 38.1% of the patients, translating to 35.7 cases/1000 ventilator-days: 45.3% were caused by gram-negative agents (Pseudomonas aeruginosa accounting for 22%); and multidrug resistant organisms were identified in 43.4%. In the ventilator-associated pneumonia group, time on mechanical ventilation, time to mechanical ventilation weaning, hospital stays and intensive care unit stays were all longer (p < 0.001). In addition, atelectasis, acute respiratory distress syndrome, pneumothorax, sinusitis, tracheobronchitis and infection with multidrug resistant organisms were more common in the ventilator-associated pneumonia group (p < 0.05). Mortality rates in the intensive care unit were comparable to those observed in the hospital infirmary. Associations between ventilator-associated pneumonia and various factors are expressed as odds ratios and 95% confidence intervals: acute sinusitis (38.8; 3.4-441); > 10 days on mechanical ventilation (7.7; 4.1-14.2); immunosuppression (4.3; 1.3-14.3); acute respiratory distress syndrome (3.5; 1.4-9.0); atelectasis (3.0; 1.2-7.3); cardiac arrest (0.18; 0.05-0.66); and upper gastrointestinal tract bleeding (0.07; 0.009-0.62). The variables found to be associated with in-hospital death were as follows: chronic renal failure (26.1; 1.9-350.7); previous intensive care unit admission (15.6; 1.6-152.0); simplified acute physiologic score II > 50 (11.9; 3.4-42.0); and age > 55 years (4.4; 1.6-12.3). Conclusion: Ventilator-associated pneumonia increased the time on mechanical ventilation and the number of complications, as well as the length of intensive care unit and hospital stays, but did not affect mortality rates.

Keywords: Bacterial pneumonia; Hospital infection; Intensive care units; Prognosis; Prospective studies; Intensive care medicine

Clinical, epidemiological, and etiological profile of inpatients with community-acquired pneumonia in a public hospital in the interior of Brazil

Perfil clínico, epidemiológico e etiológico de pacientes internados com pneumonia adquirida na comunidade em um hospital público do interior do Brasil

Laura Fuchs Bahlis1,2,3,a, Luciano Passamani Diogo3,b, Ricardo de Souza Kuchenbecker4,c, Sandra Costa Fuchs4,d

J Bras Pneumol.2018;44(4):261-266

Editorial

Community-acquired pneumonia: challenges of the situation in Brazil

Pneumonia adquirida na comunidade: os desafios da realidade brasileira

Mauro Gomes1,2,a

J Bras Pneumol.2018;44(4):254-256

Original Article

Effect of a clinical protocol on the management of acute asthma in the emergency room of a university hospital

Efeito da implantação de um protocolo assistencial de asma aguda no serviço de emergência de um hospital universitário

Pérsio Mariano da Rocha, Andréia Kist Fernandes, Fernando Nogueira, Deise Marcela Piovesan, Suzie Kang, Eduardo Franciscatto, Thaís Millan, Cristina Hoffmann, Carísi Anne Polanczyk, Sérgio Saldanha Menna Barreto, Paulo de Tarso Roth Dalcin

J Bras Pneumol.2004;30(2):94-101

Epidemiological profile of tuberculosis cases reported among health care workers at the University Hospital in Vitoria, Brazil

Perfil epidemiológico dos casos notificados de tuberculose entre os profissionais de saúde no Hospital Universitário em Vitória (ES) Brasil

Thiago Nascimento do Prado, Heleticia Scabelo Galavote, Ana Paula Brioshi, Thamy Lacerda, Geisa Fregona, Valdério do Valle Detoni, Rita de Cássia Duarte Lima, Reynaldo Dietze, Ethel Leonor Noia Maciel

J Bras Pneumol.2008;34(8):607-613

Descriptive study of the implementation and impact of the directly observed treatment, short-course strategy in the São José do Rio Preto municipal tuberculosis control program (1998-2003)

Estudo descritivo sobre a implantação da estratégia de tratamento de curta duração diretamente observado no controle da tuberculose em São José do Rio Preto e seus impactos (1998-2003)

Cláudia Eli Gazetta, Silvia Helena Fiqueiredo Vendramini, Antônio Ruffino-Netto, Maria Rita de Cássia Oliveira, Tereza Cristina Scatena Villa

J Bras Pneumol.2007;33(2):192-198

Analysis of the treatment of pulmonary tuberculosis in elderly patients at a university hospital in Rio de Janeiro, Brazil

Análise do tratamento da tuberculose pulmonar em idosos de um hospital universitário do Rio de Janeiro, RJ, Brasil

João Paulo Cantalice Filho, Márcio Neves Bóia, Clemax Couto Sant`Anna

J Bras Pneumol.2007;33(6):691-698

Editorial

Pediatric asthma - The impact of hospital admissions

Asma pediátrica - O impacto das internações hospitalares

Renato Tetelbom Stein

J Bras Pneumol.2006;32(5):25-26

Erratum

2018 recommendations for the management of community acquired pneumonia

Recomendações para o manejo da pneumonia adquirida na comunidade 2018

J Bras Pneumol.2018;44(6):532

2018 recommendations for the management of community acquired pneumonia

Recomendações para o manejo da pneumonia adquirida na comunidade 2018

J Bras Pneumol.2019;45(2):

Special Article

2018 recommendations for the management of community acquired pneumonia

Recomendações para o manejo da pneumonia adquirida na comunidade 2018

Ricardo de Amorim Corrêa1,a, Andre Nathan Costa2,b, Fernando Lundgren3.c, Lessandra Michelim4,d, Mara Rúbia Figueiredo5,e, Marcelo Holanda6,f, Mauro Gomes7,g, Paulo José Zimermann Teixeira8,h, Ricardo Martins9,i, Rodney Silva10,j, Rodrigo Abensur Athanazio2,k, Rosemeri Maurici da Silva11,l, Mônica Corso Pereira12,m

J Bras Pneumol.2018;44(5):405-423

Original Article

Adherence to guidelines and its impact on outcomes in patients hospitalized with community- acquired pneumonia at a university hospital

Adesão a diretrizes e impacto nos desfechos em pacientes hospitalizados por pneumonia adquirida na comunidade em um hospital universitário

Carla Discacciati Silveira, Cid Sérgio Ferreira, Ricardo de Amorim Corrêa

J Bras Pneumol.2012;38(2):148-157

Compliance with tuberculosis treatment after the implementation of the directly observed treatment, short-course strategy in the city of Carapicuíba, Brazil

Adesão ao tratamento da tuberculose após a instituição da estratégia de tratamento supervisionado no município de Carapicuíba, Grande São Paulo

Amadeu Antonio Vieira, Sandra Aparecida Ribeiro

J Bras Pneumol.2011;37(2):223-231

Predictors of mortality among intensive care unit patients coinfected with tuberculosis and HIV

Preditores de mortalidade em pacientes da unidade de terapia intensiva coinfectados por tuberculose e HIV

Marcia Danielle Ferreira1,2,a, Cynthia Pessoa das Neves1,3,b, Alexandra Brito de Souza3,c, Francisco Beraldi-Magalhães1,3,d, Giovanni Battista Migliori4,e, Afrânio Lineu Kritski5,f, Marcelo Cordeiro-Santos1,3,g

J Bras Pneumol.2018;44(2):118-124

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