Percorrer por autor "Zagalo, C."
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- Prevention of ventilator-associated pneumoniaPublication . Oliveira, J.; Zagalo, C.; Cavaco-Silva, P.Invasive mechanical ventilation (IMV) represents a risk factor for the development of ventilator-associated pneumonia (VAP), which develops at least 48 h after admission in patients ventilated through tracheostomy or endotracheal intubation. VAP is the most frequent intensivecare-unit (ICU)-acquired infection among patients receiving IMV. It contributes to an increase in hospital mortality, duration of MV and ICU and length of hospital stay. Therefore, it worsens the condition of the critical patient and increases the total cost of hospitalization. The introduction of preventive measures has become imperative, to ensure control and to reduce the incidence of VAP. Preventive measures focus on modifiable risk factors, mediated by nonpharmacological and pharmacological evidence based strategies recommended by guidelines. These measures are intended to reduce the risk associated with endotracheal intubation and to prevent microaspiration of pathogens to the lower airways.
- Surgical site infection prevention care bundles in colorectal surgery : a scoping reviewPublication . Cunha, T.; Miguel, S.; Maciel, J.; Zagalo, C.; Alves, P.Background: Surgical site infection (SSI) prevention bundles have been used to reduce infection rates in most types of surgery. Bundles tailored to colorectal surgery have been used with success. Aim: To identify and review the individual interventions that constitute each SSI prevention care bundle in colorectal surgery, and the reduction in SSI rate associated with their implementation. Methods: A scoping review was conducted in PubMed, CINAHL, Web of Science Core Collection and Scopus in December 2022. Results: This review analysed 48 of 164 identified studies on SSI prevention in colorectal surgery from 2011 to 2022. It revealed an average of 11 interventions per study, primarily in the pre-operative [mechanical bowel preparation, oral antibiotic bowel decontamination, hair removal, chlorhexidine gluconate (CHG) shower, normoglycaemia], intra-operative (antibiotic prophylaxis, normothermia, CHG skin preparation, antibiotic prophylaxis re-dosing, gown/glove change) and postoperative (normothermia, normoglycaemia, dressing removal, oxygen optimization, incision cleansing) periods. Despite these interventions, SSI rates remain high, indicating a need for further research to optimize intervention bundles and improve compliance across surgical stages. Conclusions: The implementation of SSI prevention bundles, tailored to colorectal surgery, has shown a reduction in SSI rates and costs. Grouping interventions according to the peri-operative phase may increase compliance.