Browsing by Author "Melo, Filipe"
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- Consensus must be found on intravenous fluid therapy management in trauma patientsPublication . Mota, Mauro Neves; Santos, M. R.; Cunha, M.; Melo, Filipe; Neves, H.; Abrantes, T.Introduction: Trauma is an important cause of death among young people and 30-40% of this mortality rate is due to hypovolemic shock, intensified by trauma's lethal triad: Hypothermia, Acidosis, and Coagulopathy. Nurses are responsible for managing fluid therapy administration in trauma victims. The purpose of this study is to analyse the reasons why intravenous fluid therapy is recommended for trauma patients' hemodynamic stabilization. Methods: This narrative literature review included published and unpublished studies in English, Spanish or Portuguese between 1994 and January 2019. The search results were analyzed by two independent reviewers. Inclusion criteria encompasses quantitative studies involving trauma victims aged over 18 who underwent fluid therapy in a prehospital assessment context. Results&Discussion: 11 quantitative studies were included. 9 involved the use of fluid therapy for hypotension treatment and 2 of the studies analyzed involved the use of warmed fluid therapy for hypothermia treatment. The analysis performed reveals that the administration of aggressive fluid therapy seems to be responsible for the worsening of the lethal triad. In the presence of traumatic brain injury, permissive hypotension is not allowed due to the negative impact on cerebral perfusion pressure. Used as warming measure, warmed fluid therapy does not seem to have a significant impact on body temperature. Conclusions: There is no consensus regarding the administration of fluid therapy to trauma patients. This conclusion clearly supports the need to develop more randomized controlled trials in order to understand the effectiveness of such measure when it comes to control hypovolemia and hypothermia.
- Impact of yoga training on heart rate variability and pilot performance: a randomized controlled trialPublication . Santos, Sara; Melo, Filipe; Fernandes, Orlando; Parraca, José AlbertoBackground Piloting military aircraft demands precise execution of maneuvers under high-stress conditions. Yoga has been proposed as a potential intervention to enhance stress management, operational performance, and flight safety in pilots. However, its effects on stress resilience and performance metrics need further investigation. Methods In this randomized controlled trial, 18 pilots were randomly assigned to either a Yoga intervention group (n=10) or a control group (n=8). Heart rate variability (HRV) measures were analyzed to evaluate physiological stress responses. Performance variables, including completion times for flight maneuvers and number of errors during emergency protocol, were also assessed before and after a 12-week intervention period. Results HRV analysis showed improvements in stress resilience, indicated by changes in heart rate variability (HRV) parameters such as standard deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD), low frequency (LF), and high frequency (HF). The Wilcoxon rank test revealed significant results regarding performance variables within the Yoga group, particularly for the Touch & Go maneuver (p=0.016) and the emergency maneuver (p=0.039), with large effect sizes (0.9444 and 0.8333, respectively). While completion times were longer for the Yoga group, indicating a more careful approach, the number of errors significantly decreased (p=0.025, effect size=0.917), with a notable reduction observed in the Yoga group compared to controls. Conclusion Incorporating yoga into pilot training protocols holds promise for better executive/cognitive functions, enhancing stress management and operational performance, reducing the number of errors, and leading to increased flight safety. While yoga may lead to longer completion times for maneuvers, the significant reduction in errors and improvements in stress resilience highlight its potential benefits. However, careful consideration is needed to balance improved precision with operational efficiency.