Avaliação de ciclo de vida comparativa entre embalagens rígidas e flexíveis

Orientador: Prof. Dr. Marcell Mariano Corrêa MacenoArtigo apresentado como trabalho de conclusão de cursoArtigo (especialização) - Universidade Federal do Paraná, Setor de Ciências Agrárias, Programa de Educação Continuada em Ciências Agrárias, Curso de Especialização em Projetos Sustentáveis e Inovações AmbientaisInclui referênciasResumo: O presente estudo apresentou como objetivo avaliar comparativamente o impacto ambiental potencial gerado por dois tipos de embalagens (uma em modelo de garrafa rígida e outra em modelo de pacote de refil flexível) de um mesmo produto, por meio da metodologia de Avaliação de Ciclo de Vida (ACV). A ACV foi realizada conforme recomendações da norma ISO 14040, com a unidade funcional sendo embalar 100 ml de detergente para roupas, em uma abordagem do berço ao túmulo. Os dados para composição do inventário de ciclo de vida foram obtidos por meio de medições reais, quando possível, e revisão da literatura. As informações foram cadastradas no software OpenLCA, utilizando a base de dados do inventário Ecoinvent v. 3.10 (2023) e o ReCiPe 2016 Midpoint (H) como método para identificação dos impactos ambientais potenciais. Após aplicação da metodologia ACV concluiu-se que a embalagem rígida apresenta maior impacto ambiental potencial em 15 das 18 categorias avaliadas pelo método selecionado. Constatou-se que o plástico PEAD foi o maior contribuinte para o resultado de ambas as embalagens. A razão de volume de embalagem por produto embalado foi um item decisório no resultado comparativo, visto que a embalagem rígida apresenta uma razão 22% maior que a flexívelAbstract: The present study aimed to compare the potential environmental impact generated by two types of packaging (a rigid bottle model and a flexible refill, stand-up pouch model) for the same product, using the Life Cycle Assessment (LCA) methodology. The LCA was conducted following the recommendations of ISO 14040 standard, and the chosen functional unit was to pack 100 ml of laundry detergent, in a cradle-to-grave approach. Data used to build life cycle inventory were obtained through real measurements, when possible, and literature review. The information was registered on OpenLCA software, using the Ecoinvent v. 3.10 (2023) inventory database and the ReCiPe 2016 Midpoint (H) method to identify potential environmental impacts. After applying the LCA methodology, the results showed that the rigid packaging had a higher potential environmental impact in 15 out of the 18 categories evaluated by the selected method. Besides, the packaging to product ratio was a decisive factor in the results, as the rigid packaging had a 22% higher ratio compared to the flexible packagin

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt