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  2. Intensive Care Units
IJCS
Original Article

Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study

André Luiz Lisboa Cordeiro et al. Wallace Fernando de Souza Lopes Tainara Conceição de Jesus Ana Julia Gomes de Oliveira … Ana Cecília de Oliveira Coutinho André Raimundo França Guimarães

Abstract

Background:

Patients with heart disease often require mechanical ventilation (MV). Although weaning protocols may reduce the duration of MV, the literature presents contradictory findings regarding their effectiveness, and there is a lack of studies specifically involving cardiac patients.

Objective:

To evaluate whether a weaning protocol reduces the duration of MV compared with weaning based on clinical judgment in cardiac patients.

Methods:

A retrospective cohort study was conducted with patients undergoing myocardial revascularization. They were randomly assigned to either the protocol-driven (intervention) group or the conventional weaning group. Weaning time, MV duration, and length of stay in the Intensive Care Unit (ICU) were assessed. Comparisons between groups were performed using the unpaired Student’s t-test. A p-value <0.05 was considered statistically significant.

Results:

A total of 214 patients were evaluated. The mean duration of MV was shorter in the intervention group (4 vs. 9 hours, p < 0.001). The mean ICU length of stay was 2 vs. 5 days in the intervention and control groups, respectively (p = 0.02).

Conclusion:

The findings suggest that protocol-guided weaning may be associated with reductions in weaning time, duration of MV, and ICU length of stay, raising the hypothesis of a potential clinical benefit that warrants further investigation in future studies.

  • Artificial Respiration
  • Clinical Protocols
  • Intensive Care Units
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Creative Commons Attribution (CC BY) Creative Commons license
07/09/2026 DOI: 10.36660/ijcs.20240209 Visualizações 11
IJCS
Original Article

Applicability of SAPS 3 and APACHE II Scores in a Cardiac Intensive Care Unit: A Prospective Study

Rafael Petri Pinheiro et al. Leonardo Castro Luna Vanessa dos Reis von Doellinger Marcelo Goulart Correia … Bernardo Tura Stephan Lachtermacher

Abstract

Background

Prognostic scores such as the Simplified Acute Physiology Score (SAPS) and the Acute Physiology and Chronic Health Evaluation (APACHE) are essential for assessing performance and predicting mortality in Intensive Care Units (ICUs).

Objectives

To evaluate the performance of SAPS 3 (including the Latin America [LA] and Brazil [BR] versions) and APACHE II in predicting mortality in a cardiac intensive care unit (CICU).

Methods

Prospective cohort of patients admitted between June 2022 and May 2024, followed until discharge or death. Data were extracted from electronic medical records. The relationship between observed and predicted mortality was calculated using the Standardized Mortality Ratio (SMR), and discrimination was assessed by the Receiver Operating Characteristic (ROC) curve.

Results

A total of 573 patients were included, 288 (50%) with three or more comorbidities, median age 63 years [IQR: 53–72], and 344 (60%) male. Cardiovascular diseases accounted for 76% of admissions. Overall mortality was 15%. Mean SMR values were: 0.52 (95% CI: 0.32–0.72) for SAPS 3; 0.40 (95% CI: 0.26–0.54) for SAPS 3 Latin America (AL); 0.79 (95% CI: 0.41–1.16) for SAPS 3 Brazil (BR); and 0.86 (95% CI: 0.42–1.29) for APACHE II. The analysis of the area under the curve (AUC) was 0.805 for SAPS 3 and its adapted versions, and 0.704 for APACHE II.

Conclusions

SAPS 3, particularly SAPS 3 Brazil (BR), demonstrated greater accuracy than APACHE II. Despite mortality being above the national average, the SMR indicated that observed mortality was lower than predicted, suggesting good care performance in the unit.

  • APACHE
  • Cardiology
  • Hospital Mortality
  • Intensive Care Units
  • Simplified Acute Physiology Score
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Creative Commons Attribution (CC BY) Creative Commons license
27/04/2026 DOI: 10.36660/ijcs.20250071 Visualizações 8
IJCS
Editorial

Risk Factors for Mortality in Pediatric Cardiac Intensive Care Unit

Cristiane Martins et al. Bruna M. N. Gama

Congenital heart defect commonly requires care in pediatric intensive care unit (PICU). They are a heterogeneous group of disorders with an annual incidence of 25,757 new cases in Brazil, 12 cases per 1,000 inhabitants . In this paper, Guimarães et al., published a cross-sectional study to describe the epidemiology of patients admitted to PICU from a tertiary hospital in Brazil. In this editorial, we review recent progress in understanding the risk factors for mortality in PICU. The editorial was produced by searching Pubmed and Scielo, using the terms “PICU”, “RACHS”, “CHD”, and “mortality”.

Congenital heart defects (CHD) are serious and common conditions that have a significant impact on morbidity, mortality and healthcare costs in both children and adults. It is estimated that at least 32,000 infants in the United States will be affected each year by CHD. Of these, approximately 25%, or 2.4 per 1,000 live births require invasive treatment in the first year of life. While advances in treatment in the last decades have decreased infant mortality, they have also led to an increase in the number of children and adults with CHD. Despite these advances and developments in interventional and surgical techniques, heart disease in children remains an important cause of morbidity and mortality.

[…]

  • Aortic Coarctation
  • Arterial Switch Operation
  • Heart Defects Congenital/mortality
  • Heart Septal Defects, Ventricular
  • Hospitalization
  • Intensive Care Units
  • Mordity
  • Risk Factors
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Creative Commons Attribution (CC BY) Creative Commons license
31/07/2020 DOI: 10.36660/ijcs.20200130 Visualizações 5

Como citar este artigo

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Cordeiro ALL, Lopes WFS, Jesus TC, Oliveira AJG, Coutinho ACO, Guimarães ARF. Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study. International Journal of Cardiovascular Sciences 2026;39:e20240209.

Formato de Documento Eletrônico (ABNT)

Cordeiro, André Luiz Lisboa; Lopes, Wallace Fernando de Souza; Jesus, Tainara Conceição de; Oliveira, Ana Julia Gomes de; Coutinho, Ana Cecília de Oliveira; Guimarães, André Raimundo França. Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study. International Journal of Cardiovascular Sciences, v. 39, e20240209, set. 2026.

Formato de Documento Eletrônico (APA)

Cordeiro, A. L. L., Lopes, W. F. S., Jesus, T. C. , Oliveira, A. J. G. , Coutinho, A. C. O., & Guimarães, A. R. F. (2026). Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study. International Journal of Cardiovascular Sciences, 39, e20240209.

Formato de Documento Eletrônico (ISO)

Cordeiro, André Luiz Lisboa and Lopes, Wallace Fernando de Souza and Jesus, Tainara Conceição de and Oliveira, Ana Julia Gomes de and Coutinho, Ana Cecília de Oliveira and Guimarães, André Raimundo França. Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study. International Journal of Cardiovascular Sciences [online]. 2026, vol. 39, [citado 2026-11-15], e20240209. Disponível em: <https://journals.cardiol.br/article/protocol-for-weaning-from-mechanical-ventilation-in-patients-undergoing-coronary-artery-bypass-grafting-cohort-study-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Pinheiro RP, Luna LC, Doellinger VR, Correia MG, Tura B, Lachtermacher S. Applicability of SAPS 3 and APACHE II Scores in a Cardiac Intensive Care Unit: A Prospective Study. International Journal of Cardiovascular Sciences 2026;39:e20250071.

Formato de Documento Eletrônico (ABNT)

Pinheiro, Rafael Petri; Luna, Leonardo Castro; Doellinger, Vanessa dos Reis von; Correia, Marcelo Goulart; Tura, Bernardo; Lachtermacher, Stephan. Applicability of SAPS 3 and APACHE II Scores in a Cardiac Intensive Care Unit: A Prospective Study. International Journal of Cardiovascular Sciences, v. 39, e20250071, abr. 2026.

Formato de Documento Eletrônico (APA)

Pinheiro, R. P., Luna, L. C., Doellinger, V. R. , Correia, M. G., Tura, B., & Lachtermacher, S. (2026). Applicability of SAPS 3 and APACHE II Scores in a Cardiac Intensive Care Unit: A Prospective Study. International Journal of Cardiovascular Sciences, 39, e20250071.

Formato de Documento Eletrônico (ISO)

Pinheiro, Rafael Petri and Luna, Leonardo Castro and Doellinger, Vanessa dos Reis von and Correia, Marcelo Goulart and Tura, Bernardo and Lachtermacher, Stephan. Applicability of SAPS 3 and APACHE II Scores in a Cardiac Intensive Care Unit: A Prospective Study. International Journal of Cardiovascular Sciences [online]. 2026, vol. 39, [citado 2026-11-15], e20250071. Disponível em: <https://journals.cardiol.br/article/applicability-of-saps-3-and-apache-ii-scores-in-a-cardiac-intensive-care-unit-a-prospective-study-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Martins C, Gama BMN. Risk Factors for Mortality in Pediatric Cardiac Intensive Care Unit. International Journal of Cardiovascular Sciences 2020;33(4):337-9.

Formato de Documento Eletrônico (ABNT)

Martins, Cristiane; Gama, Bruna M. N.. Risk Factors for Mortality in Pediatric Cardiac Intensive Care Unit. International Journal of Cardiovascular Sciences, v. 33, n. 4, p. 337-339, jul. 2020.

Formato de Documento Eletrônico (APA)

Martins, C., & Gama, B. M. N. (2020). Risk Factors for Mortality in Pediatric Cardiac Intensive Care Unit. International Journal of Cardiovascular Sciences, 33(4), 337-339.

Formato de Documento Eletrônico (ISO)

Martins, Cristiane and Gama, Bruna M. N.. Risk Factors for Mortality in Pediatric Cardiac Intensive Care Unit. International Journal of Cardiovascular Sciences [online]. 2020, vol. 33, n. 4, [citado 2026-11-15], pp. 337-339. Disponível em: <https://journals.cardiol.br/article/risk-factors-for-mortality-in-pediatric-cardiac-intensive-care-unit-2/>. ISSN 2359-4802

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