Emergências e Terapia Intensiva

Comentário de estudo | Cateterização cardíaca imediata vs. tardia em pacientes pós-parada cardíaca sem infarto do miocárdio com elevação do segmento ST: o viés de sobrevivência é uma influência importante?

11 Abr, 2022 | 12:44h

Immediate Versus Delayed Cardiac Catheterization in Post-Arrest Patients Without ST Elevation Myocardial Infarction: Is Survivorship Bias an Important Influence? – Annals of Emergency Medicine

Estudo original: #ESCCongress – RCT: Immediate coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation did not improve outcomes compared to delayed/selective angiography.

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Comentário de estudo | De volta ao BaSICS (estudo que comparou solução balanceada com solução salina a 0,9% em pacientes críticos).

11 Abr, 2022 | 12:43h

Back to BaSICS – Annals of Emergency Medicine

Estudos originais:

BaSICS RCT: Among critically ill patients requiring fluid therapy, treatment with a balanced solution did not lead to reduced mortality compared to a 0.9% saline solution.

BaSICS RCT: Among critically ill patients requiring fluid therapy, there was no difference in mortality with slower (333 mL/h) vs. faster (999 mL/h) intravenous fluid bolus rates.

Conteúdos relacionados:

Perspective: The ongoing saga of normal saline vs. balanced fluids.

RCT: In critically ill adults, using a balanced multielectrolyte solution did not lower the risk of death or acute kidney injury compared to standard saline.

Balanced Crystalloids versus Saline in Critically Ill Adults — A Systematic Review with Meta-Analysis – NEJM Evidence

Cochrane Review: Buffered Solutions Do Not Improve Mortality in Critically Ill Adults and Children Compared to 0,9% Saline

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Comentário de estudo | Bougie vs. Stylet para entubação bem-sucedida na primeira passagem.

11 Abr, 2022 | 12:41h

To Bougie or Not to Bougie: Bougie versus Stylet for First-Pass Intubation Success – Annals of Emergency Medicine

Estudo original: RCT: In critically ill adults undergoing tracheal intubation, use of a bougie did not significantly increase the incidence of successful first attempt intubation vs. with use of an endotracheal tube with stylet.

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Breve revisão | Como fazer ultrassonografia torácica.

11 Abr, 2022 | 12:32h

How to do lung ultrasound – European Heart Journal – Cardiovascular Imaging

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Estudo mostra risco aumentado de embolia pulmonar em até 110 dias após a COVID-19.

8 Abr, 2022 | 21:58h

Risks of deep vein thrombosis, pulmonary embolism, and bleeding after covid-19: nationwide self-controlled cases series and matched cohort study – The BMJ

Comunicado de imprensa: Study finds increased risk of serious blood clots up to six months after COVID-19 – BMJ

Editorial: Thromboembolism and bleeding after covid-19

Comentário: Covid: Blood clot risk higher for six months after having virus – BBC

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Estudo randomizado pragmático | Em pacientes ambulatoriais com COVID-19, a adição da oximetria de pulso para monitoramento não melhorou os desfechos em comparação a avaliações subjetivas isoladas da dispneia.

8 Abr, 2022 | 21:54h

Pulse Oximetry for Monitoring Patients with Covid-19 at Home — A Pragmatic, Randomized Trial – New England Journal of Medicine

 

Comentário no Twitter

A potential practice changer by @kit_delgadoMD et al in NEJM today.

At-home pulse oximeters did NOT improve outcomes.

Important to focus on things that help.

If these devices don't help, then we shouldn't routinely advise them.

Super interesting work.https://t.co/VDDyRLw7ba

— Jeremy Faust MD MS (ER physician) (@jeremyfaust) April 6, 2022

 

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Estudo randomizado | Entre pacientes com infecção complicada de trato urinário, o uso oral de tebipenem pivoxil hidrobromida foi não inferior ao ertapenem intravenoso e mostrou perfil de segurança similar.

8 Abr, 2022 | 21:50h

Oral Tebipenem Pivoxil Hydrobromide in Complicated Urinary Tract Infection – New England Journal of Medicine (link para o resumo – $ para o texto completo)

 

Comentário no Twitter

For complicated UTI or acute pyelonephritis, oral tebipenem pivoxil hydrobromide noninferior to IV ertapenem and has a similar safety profile. https://t.co/FRDMQOD0Pn pic.twitter.com/GFQz7SlciX

— NEJM (@NEJM) April 6, 2022

 

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Estudo randomizado | Em pacientes submetidos a tratamento intra-arterial para AVC, tanto a anestesia geral quanto a sedação tiveram desfechos funcionais similares após 3 meses.

8 Abr, 2022 | 21:24h

General Anesthesia versus Sedation, Both with Hemodynamic Control, during Intraarterial Treatment for Stroke: The GASS Randomized Trial – Anesthesia

 

Comentário no Twitter

Previous speculations have considered the relationship between anesthetic strategy and patient outcomes. Now, new research suggests general #anesthesia and #sedation produce comparable outcomes after endovascular treatment for stroke. https://t.co/ggLRO8Or3W pic.twitter.com/dLLGA4Vmgk

— Anesthesiology journal (@_Anesthesiology) March 24, 2022

 

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Grandes queimados – Parte 2 | Anestesia, terapia intensiva e manejo da dor.

8 Abr, 2022 | 21:22h

Major burns: part 2. Anaesthesia, intensive care and pain management – BJA Education

Ver também: Major burns: Part 1. Epidemiology, pathophysiology and initial management.

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Estudo randomizado | Efeitos do clazosentam sobre a morbidade e a mortalidade por todas as causas relacionadas ao vasoespasmo cerebral após hemorragia subaracnóidea aneurismática.

8 Abr, 2022 | 17:23h

Effects of clazosentan on cerebral vasospasm–related morbidity and all-cause mortality after aneurysmal subarachnoid hemorrhage: two randomized phase 3 trials in Japanese patients – Journal of Neurosurgery

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