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Auteur principal:	Daniela Ruy C. Barros
Format:	Artículo científico
Langue:	pt
Publié:	Sociedade de Pediatria de São Paulo 2011
Sujets:	Medicina pediatria Respiração artficial cuidados intensivos
Accès en ligne:	https://www.redalyc.org/articulo.oa?id=406038938007
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Relação entre índice de oxigenação e ventilação com o tempo em ventilação mecânica de pacientes em terapia intensiva pediátrica Daniela Ruy C. Barros Celize Cruz B. Almeida Armando Augusto A. Júnior Rosângela Alves Grande Maria Ângela G. O. Ribeiro José Dirceu Ribeiro Medicina pediatria Respiração artficial cuidados intensivos Objetivo: Correlacionar o índice de oxigenação (IO) e o de ventilação (IV) com o tempo de ventilação mecânica invasiva (VMI) em pacientes pediátricos. Métodos: Estudo prospectivo, observacional, com pa-cientes de 28 dias de vida a 14 anos de idade, internados na Unidade de Terapia Intensiva Pediátrica de um hospital universitário. Correlacionaram-se valores de idade, peso, pH, pressão parcial de oxigênio (PaO2), pressão parcial de gás carbônico (PaCO2), IO e IV, nos primeiros cinco dias em VMI, com o tempo em que o paciente permaneceu em VMI. O tempo total de ventilação mecânica foi dividido em <7 dias e ≥7 dias.Resultados: Foram estudados 28 pacientes. Houve cor-relação negativa significante do tempo de VMI com o pH no quarto dia e com a PaO2 no quinto dia. Houve correlação positiva com o IO no terceiro e quarto dias e com o IV no terceiro, quarto e quinto dias. Houve diferença na idade e pH no quarto e quinto dias e IV do segundo ao quinto dias entre o grupo que permaneceu menos de sete dias e o que permaneceu sete dias ou mais em VMI. Conclusões: IO, IV, pH e PaO2, medidos precocemente, associaram-se com VMI prolongada, refletindo a gravidade do distúrbio ventilatório inicial. 2011 artículo científico 0103-0582 https://www.redalyc.org/articulo.oa?id=406038938007 pt http://www.redalyc.org/revista.oa?id=4060 Revista Paulista de Pediatria application/pdf Sociedade de Pediatria de São Paulo Revista Paulista de Pediatria (Brasil) Num.3 Vol.29

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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