MANEJO DA RESSUSCITAÇÃO CARDIOPULMONAR NO NEONATO

INTRODUÇÃO: A ressucitação cardiopulmonar (RCP) neonatal é a aplicação de manobras que dever ser executada de forma eficaz quando diagnósticado a PCR, visando promover o aporte sanguineno apropriado para o cerebro e orgão vitais, sendo realizado o a frequencia e profunidade das compressões toracicas de forma que melhore a perfusão cardiaca e cerebral, que deve ser iniciada após a detecção precoce. OBJETIVOS: evidenciar as práticas de manejo da ressuscitação cardiopulmonar neonatal. MÉTODOS: Revisão integrativa, realizada com base na pergunta norteadora: " Qual o manejo para a ressucitação cardiopulmonar em neonatos?”, através de artigos em língua portuguesa e inglesa, publicados no período de 2018 a 2023, originados das bases de dados MEDLINE, SciELO, BDENF-Enfermagem, LILACS. Realizou-se a coleta de dados em agosto de 2023. RESULTADOS: A amostra foi constituída por 8 artigos, que denotaram um núcleo: Atuação da equipe na sala de parto no manejo da ressuscitação cardiopulmonar em neonatos. CONCLUSÃO: As manobras de RCP, trouxe a percepção a importância dos profissionais em se atualizar, aumentando sua bagagem de conhecimento técnico-científico, a fim de proporcionar assistência adequada à RNs e suas famílias, para que, assim, alcance resultado eficaz em tempo reduzido, e promovendo a redução de complicações decorrentes a PCR

O impacto da pandemia no papel da enfermagem: uma revisão narrativa da literatura

Objective: To analyze, describe and explain the impact of the pandemic on the role of nursing, according to literature.Method: Narrative review of the literature based on searches in databases (Pubmed, BDENF, Scielo, Google Scholar), on the references of articles, and official websites. The search used the combination of descriptors: COVID-19 and Enfermagem and Pandemia and only COVID- 19.Results: 44 references were selected, according to the inclusion criteria. It was shown that the pandemic impact the routines of nursing work in many ways, affecting the updating of measures to prevent occupational infections and protective equipment-related pressure injuries, mental health care, the proportion of infection among nurses, although it brings more visibility and recognition to the importance of nursing workers in health care.Conclusion: The pandemic forced nurses to submit to new working conditions, which caused personal and labor issues that are associated with the quality of health care.Objetivo: Analizar, describir y explicar el impacto de la pandemia en el rol de la enfermería, según la literatura.Método: Revisión narrativa de la literatura basada en búsquedas en bases de datos (Pubmed, BDENF, Scielo, Google Scholar), sección de referencia de artículos y sitios web oficiales con la combinación de descriptores: COVID-19 y Enfermagem y Pandemia y solo COVID- 19.Resultados: Se seleccionaron 44 referencias, de acuerdo al criterio de inclusión, para lo cual se evidenció que la pandemia impacta desde cambios en las rutinas del trabajo de enfermería, actualización de medidas para prevenir infecciones ocupacionales y lesiones por presión por uso de equipo de protección, atención a la salud mental, proporción de infección entre enfermeras para una mayor visibilidad y reconocimiento de la importancia de la categoría en la atención de la salud.Conclusión: La pandemia impuso nuevas condiciones laborales al personal de enfermería, las cuales impactaron en temas personales y laborales que se interrelacionan con la calidad de la atención de salud.  Objetivo: Analisar, descrever e explicitar o impacto da pandemia no papel da enfermagem, conforme a literatura. Método: Revisão narrativa da literatura a partir de pesquisas em bases de dados (Pubmed, BDENF, Scielo, Google Scholar), seção de referência dos artigos e sites oficiais com a combinação dos descritores: COVID-19 and Enfermagem and Pandemia e apenas COVID-19. Resultados: Foram selecionadas 44 referências, consoante o critério de inclusão, por quais evidenciou-se que a pandemia impacta desde mudanças nas rotinas do trabalho da enfermagem, atualização de medidas de prevenção de infecção ocupacional e de lesões por pressão por uso de equipamentos de proteção, cuidados para com a saúde mental, proporção de infecção entre os enfermeiros até maior visibilidade e reconhecimento da importância da categoria na assistência à saúde. Conclusão: A pandemia impôs novas condições de trabalho ao pessoal de enfermagem, as quais impactaram em questões pessoais e trabalhistas que se inter-relacionam com a qualidade da assistência à saúde

The impact of the pandemic on the role of nursing: a narrative review of the literature

Objetivo: Analizar, describir y explicar el impacto de la pandemia en el rol de la enfermería, según la literatura. Método: Revisión narrativa de la literatura basada en búsquedas en bases de datos (Pubmed, BDENF, Scielo, Google Scholar), sección de referencia de artículos y sitios web oficiales con la combinación de descriptores: COVID-19 y Enfermagem y Pandemia y solo COVID- 19.Resultados: Se seleccionaron 44 referencias, de acuerdo al criterio de inclusión, para lo cual se evidenció que la pandemia impacta desde cambios en las rutinas del trabajo de enfermería, actualización de medidas para prevenir infecciones ocupacionales y lesiones por presión por uso de equipo de protección, atención a la salud mental, proporción de infección entre enfermeras para una mayor visibilidad y reconocimiento de la importancia de la categoría en la atención de la salud. Conclusión: La pandemia impuso nuevas condiciones laborales al personal de enfermería, las cuales impactaron en temas personales y laborales que se interrelacionan con la calidad de la atención de salud.Objetivo: Analisar, descrever e explicitar o impacto da pandemia no papel da enfermagem, conforme a literatura. Método: Revisão narrativa da literatura a partir de pesquisas em bases de dados (Pubmed, BDENF, Scielo, Google Scholar), seção de referência dos artigos e sites oficiais com a combinação dos descritores: COVID-19 and Enfermagem and Pandemia e apenas COVID-19. Resultados: Foram selecionadas 44 referências, consoante o critério de inclusão, por quais evidenciou-se que a pandemia impacta desde mudanças nas rotinas do trabalho da enfermagem, atualização de medidas de prevenção de infecção ocupacional e de lesões por pressão por uso de equipamentos de proteção, cuidados para com a saúde mental, proporção de infecção entre os enfermeiros até maior visibilidade e reconhecimento da importância da categoria na assistência à saúde. Conclusão: A pandemia impôs novas condições de trabalho ao pessoal de enfermagem, as quais impactaram em questões pessoais e trabalhistas que se inter-relacionam com a qualidade da assistência à saúde.Objective: To analyze, describe and explain the impact of the pandemic on the role of nursing, according to literature. Method: Narrative review of the literature based on searches in databases (Pubmed, BDENF, Scielo, Google Scholar), on the references of articles, and official websites. The search used the combination of descriptors: COVID-19 and Enfermagem and Pandemia and only COVID- 19. Results: 44 references were selected, according to the inclusion criteria. It was shown that the pandemic impact the routines of nursing work in many ways, affecting the updating of measures to prevent occupational infections and protective equipment-related pressure injuries, mental health care, the proportion of infection among nurses, although it brings more visibility and recognition to the importance of nursing workers in health care. Conclusion: The pandemic forced nurses to submit to new working conditions, which caused personal and labor issues that are associated with the quality of health care

Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database

Background: Survival benefit from low tidal volume (VT) ventilation (LTVV) has been demonstrated for patients with acute respiratory distress syndrome (ARDS), and patients not having ARDS could also benefit from this strategy. Organizational factors may play a role on adherence to LTVV. The present study aimed to identify organizational factors with an independent association with adherence to LTVV. Methods: Secondary analysis of the database of a multicenter two-phase study (prospective cohort followed by a cluster-randomized trial) performed in 118 Brazilian intensive care units. Patients under mechanical ventilation at day 2 were included. LTVV was defined as a VT ≤ 8 ml/kg PBW on the second day of ventilation. Data on the type and number of beds of the hospital, teaching status, nursing, respiratory therapists and physician staffing, use of structured checklist, and presence of protocols were tested. A multivariable mixed-effect model was used to assess the association between organizational factors and adherence to LTVV. Results: The study included 5719 patients; 3340 (58%) patients received LTVV. A greater number of hospital beds (absolute difference 7.43% [95% confidence interval 0.61–14.24%]; p = 0.038), use of structured checklist during multidisciplinary rounds (5.10% [0.55–9.81%]; p = 0.030), and presence of at least one nurse per 10 patients during all shifts (17.24% [0.85–33.60%]; p = 0.045) were the only three factors that had an independent association with adherence to LTVV. Conclusions: Number of hospital beds, use of a structured checklist during multidisciplinary rounds, and nurse staffing are organizational factors associated with adherence to LTVV. These findings shed light on organizational factors that may improve ventilation in critically ill patients

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used