Improving critical care through telemedicine: a comprehensive analysis of a Tele-ICU project in northern and northeastern regions of Brazil.

Introduction: The Tele-Intensive Care Unit (Tele-ICU) project aimed to standardize and improve the quality of critical care services, particularly in regions where access to specialized care and resources remains limited. We herein provide a detailed overview of the implementation of the Tele-ICU project in Brazil's northern and northeastern regions, describing its multi-modal approach, which combined telemedicine implementation, educational initiatives, simulation-based training, protocol development, and structured data reporting to enhance critical care delivery.

Methods: The implementation of the Tele-ICU project, developed in a partnership between the Ministry of Health and Hospital Sírio-Libanês from June 2022 to December 2023, was supported by the Support Program for Institutional Development of the Unified Health System (PROADI-SUS).

Pathophysiological and Clinical Significance of Venom-Induced Pulmonary Impairment in a Murine Model.

Crotalus venom has broad biological activity, including neurotoxic, myotoxic, hematologic, and cytotoxic compounds that induce severe systemic repercussions. We evaluated the pathophysiological and clinical significance of (Cdc) venom-induced pulmonary impairment in mice. We conducted a randomized experimental study, involving 72 animals intraperitoneally inoculated with saline solution in the control group (CG), as well as venom in the experimental group (EG).

Evaluation of systemic inflammatory response and lung injury induced by Crotalus durissus cascavella venom.

This study investigated the systemic inflammatory response and mechanism of pulmonary lesions induced by Crotalus durissus cascavella venom in murine in the state of Bahia. In order to investigate T helper Th1, Th2 and Th17 lymphocyte profiles, we measured interleukin (IL) -2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor (TNF) and interferon gamma (IFN-γ) levels in the peritoneal fluid and macerated lungs of mice and histopathological alterations at the specific time windows of 1h, 3h, 6h, 12h, 24h and 48h after inoculation with Crotalus durissus cascavella venom. The data demonstrated an increase of acute-phase cytokines (IL-6 and TNF) in the first hours after inoculation, with a subsequent increase in IL-10 and IL-4, suggesting immune response modulation for the Th2 profile.

Unidirectional Expiratory Valve Method to Assess Maximal Inspiratory Pressure in Individuals without Artificial Airway.

Introduction: Maximal Inspiratory Pressure (MIP) is considered an effective method to estimate strength of inspiratory muscles, but still leads to false positive diagnosis. Although MIP assessment with unidirectional expiratory valve method has been used in patients undergoing mechanical ventilation, no previous studies investigated the application of this method in subjects without artificial airway.

Objectives: This study aimed to compare the MIP values assessed by standard method (MIPsta) and by unidirectional expiratory valve method (MIPuni) in subjects with spontaneous breathing without artificial airway.