Emergências e Terapia Intensiva

Gota no departamento de emergência: dicas e armadilhas.

27 Abr, 2022 | 16:03h

Gout in the ED: Pearls and Pitfalls – emDocs

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Estudo observacional multinacional | Achados ecocardiográficos em pacientes com COVID-19 admitidos em UTI.

27 Abr, 2022 | 15:43h

Echocardiography findings in COVID-19 patients admitted to intensive care units: a multi-national observational study (the ECHO-COVID study) – Intensive Care Medicine

 

Comentário no Twitter

Echocardiography in #COVID19 #ICU pts, ECHO-COVID study
♥︎ systolic dysfunction in ⅓: 23% LV (similar to septic cardiomyopathy), 22.5% RV (due to P overload)
♥︎ ACP in 17% (due to hypercapnia, PE, MV)
♥︎ ACP/age associated with in-ICU mortality
📖 https://t.co/NUlAZh9hHw pic.twitter.com/t17pNolFqy

— Intensive Care Medicine (@yourICM) April 21, 2022

 

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OMS recomenda o nirmatrelvir-ritonavir para o tratamento da COVID-19 e pede para uma maior distribuição geográfica.

25 Abr, 2022 | 12:47h

WHO recommends highly successful COVID-19 therapy and calls for wide geographical distribution and transparency from originator – World Health Organization

Ver também:

A living WHO guideline on drugs for covid-19 – The BMJ

Therapeutics and COVID-19: living guideline – World Health Organization

Conteúdos relacionados:

Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19 – New England Journal of Medicine

Prescribing Nirmatrelvir–Ritonavir: How to Recognize and Manage Drug–Drug Interactions – Annals of Internal Medicine

The COVID-19 Treatment Guidelines Panel’s Statement on Potential Drug-Drug Interactions Between Ritonavir-Boosted Nirmatrelvir (Paxlovid) and Concomitant Medications – NIH COVID-19 Treatment Guidelines Panel

 

Comentário no Twitter

🔥 Our latest @WHO living guidance on drugs for #COVID19, with new recommendations for nirmatrelvir-ritonavir & updated recommendation for remdesivir in non-severe illness.@bmj_latest: https://t.co/KuJjwzeTPV@WHO: https://t.co/n3iQx3pdmY@theMAGICapp: https://t.co/dA7YYzeAZ1 pic.twitter.com/LvAhJf70UY

— Arnav Agarwal (@ArnavAgarwalMD) April 21, 2022

 

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Seguimento de 1 ano de estudo randomizado | Em pacientes em UTI com hipoxemia grave, não houve diferença na mortalidade de longo prazo e na qualidade de vida relacionada à saúde com alvos de oxigenação mais baixos vs. mais altos.

25 Abr, 2022 | 12:42h

Long-term mortality and health-related quality of life of lower versus higher oxygenation targets in ICU patients with severe hypoxaemia – Intensive Care Medicine

Estudo original: Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure – New England Journal of Medicine

 

Comentário no Twitter

Lower (8 kPa) vs higher oxygenation (12 kPa) targets: no longterm survival benefit nor HRQoL improvement at 1y in #ICU pts with severe hypoxaemia (HOT-ICU trial cohort). Substantial impairments in several EQ-5D-5L dimensions in survivors in both groups.
🖇️ https://t.co/P48Cd5sIWK pic.twitter.com/JBFEIqDdcB

— Intensive Care Medicine (@yourICM) April 20, 2022

 

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Diretriz de especialistas | Estratégias para prevenir infecções de corrente sanguínea por cateter central em hospitais de cuidado agudo.

21 Abr, 2022 | 12:41h

Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update – Infection Control & Hospital Epidemiology

 

Comentário no Twitter

Prevention of central line-associated bloodstream infections in acute-care hospitals- 2022 updatehttps://t.co/o3AReYvJIu pic.twitter.com/QsgYYezhqj

— K Pavithran (@drkpavithran) April 19, 2022

Artigo sob licença de http://creativecommons.org/licenses/by/4.0/

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Estudo controlado não randomizado: posição prona em paciente não intubado (média de 4,2 horas/dia) pode não ser benéfica para adultos internados com Covid-19.

21 Abr, 2022 | 12:29h

Assessment of Awake Prone Positioning in Hospitalized Adults With COVID-19: A Nonrandomized Controlled Trial – JAMA Internal Medicine

Comentários:

Prone Positioning for Nonintubated Patients With COVID-19—Potential Dangers of Extrapolation and Intermediate Outcome Variables – JAMA Internal Medicine

Study suggests worse outcomes for awake COVID patients in prone position – CIDRAP

Putting Hospitalized COVID Patients on Their Belly May Not Be a Good Idea After All – HealthDay

Conteúdos relacionados:

Awake prone positioning for non-intubated patients with COVID-19-related acute hypoxaemic respiratory failure: a systematic review and meta-analysis – The Lancet Respiratory Medicine

Prone positioning of patients with moderate hypoxaemia due to covid-19: multicentre pragmatic randomised trial (COVID-PRONE) – The BMJ

RCT: Prone positioning of patients with moderate hypoxia due to COVID-19 – medRxiv

Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial – The Lancet Respiratory Medicine

Awake prone positioning in patients with hypoxemic respiratory failure due to COVID-19: the PROFLO multicenter randomized clinical trial – Critical Care

Prone Positioning of Nonintubated Patients With Coronavirus Disease 2019—A Systematic Review and Meta-Analysis – Critical Care Medicine

 

Comentário no Twitter (fio – clique para saber mais)

Important negative study: non randomized trial finds no clinical benefit to awake proning vs usual care in COVID

No difference in rates of intubation, length of stay, or 28 day mortality

Medicine is humbling. This emphasizes the importance of trials
📄https://t.co/ksh9Ic9XBL
1/ pic.twitter.com/sjHHv4WQs8

— Nick Mark MD (@nickmmark) April 18, 2022

 

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Diretriz AAOS | Prevenção de infecções em sítio cirúrgico após trauma extenso em extremidades.

21 Abr, 2022 | 11:46h

Prevention of Surgical Site Infections After Major Extremity Trauma: Evidence-Based Clinical Practice Guideline – American Academy of Orthopaedic Surgeons

Revisão de evidência: Prevention of Surgical Site Infection After Extremity Trauma (2022)

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Índice de estresse e ativação endotelial (EASIX – endothelial activation and stress index) pré-transplante pode predizer danos causados por sepse após transplante alogênico de células-tronco.

21 Abr, 2022 | 11:30h

Pre-transplant EASIX and sepsis after allogeneic stem cell transplantation – Intensive Care Medicine

 

Comentário no Twitter

🧪 Endothelial complications major causes of mortality post alloSCT. Pre Tx Endothelial Activation & Stress IndeX EASIX (basic lab data characterizing Tx-associated thrombotic microangiopathy) powerful marker of #sepsis, dysfunctional endothelial response.https://t.co/FRGUGT8L78 pic.twitter.com/VF2wTLCHaM

— Intensive Care Medicine (@yourICM) April 18, 2022

 

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Hepatite aguda no departamento de emergência: etiologias, avaliação e tratamento.

21 Abr, 2022 | 11:29h

Acute Hepatitis in ED Setting: Etiologies, Evaluation, and Management – emDocs

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Diretrizes para o monitoramento terapêutico medicamentoso da vancomicina.

19 Abr, 2022 | 12:37h

Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring – Pharmaceutics

Diretriz relacionada:

Diretriz: Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists

Resumo: Therapeutic Monitoring of Vancomycin for Serious Methicillin-resistant Staphylococcus aureus Infections: A Revised Consensus Guideline and Review by the American Society of Health-system Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists – Clinical Infectious Diseases

 

Comentário no Twitter

🔔Rings Cowbell🔔
New Vancomycin guidelines drop from Japan.

This is the most written about the need for #PrecisionDosing that I have seen.

Give patients the dose they need because #OneSizeFitsNone@SIDPharm @ABsteward @IDstewardship https://t.co/wlwgkqZmXu

— Marc H. Scheetz (@IDPharmacometrx) April 13, 2022

 

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