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Acesso livre

Emergências e Terapia Intensiva

Diretriz atualizada da OMS recomenda condicionalmente o molnupiravir para pacientes com Covid-19 não grave sob alto risco de internação.

8 Mar, 2022 | 16:14h

Comunicado de imprensa BMJ: WHO recommends antiviral drug for patients with non-severe covid-19 at highest risk of hospital admission – BMJ

Comunicado de imprensa OMS: WHO updates its treatment guidelines to include molnupiravir

Ver diretriz atualizada: A living WHO guideline on drugs for covid-19 – BMJ

Conteúdos relacionados:

Editorial (recém-publicado): Molnupiravir’s authorisation was premature – The BMJ

RCT: Molnupiravir reduced the risk of hospitalization or death in at-risk (i.e., obesity, over 60 years, etc.) unvaccinated adults with Covid-19.

Merck’s COVID pill loses its luster: what that means for the pandemic – “Molnupiravir was initially heralded by public-health officials as a game-changer for COVID-19, but full clinical-trial data showed lower-than-expected efficacy”.

FDA panel narrowly recommends authorization of first antiviral pill to treat COVID.

[Press release – not published yet] Merck’s new Covid-19 pill Molnupiravir updated data shows reduced efficacy (30%) for preventing hospitalization and death compared to initial results (50%). Absolute risk reduction of hospitalization and death fell from 7% to 3%.

8 lingering questions about the new Covid pills from Merck and Pfizer.

COVID antiviral pills: what scientists still want to know – “Drugs like Molnupiravir and Paxlovid could change the course of the pandemic if clinical trial results hold up in the real world”.

[Press release – not published yet] RCT: Pfizer’s novel Covid-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of phase 2/3 EPIC-HR study.

A prominent virologist warns new COVID-19 pill could unleash dangerous mutants. Others see little cause for alarm.

The U.K. approves Merck’s COVID-19 antiviral pill, calling it a world first.

Merck to allow other nations to produce new COVID-19 antiviral.

Video: Merck’s Covid pill could transform treatment. Here’s how it works.

How antiviral pill Molnupiravir shot ahead in the COVID drug hunt.

What we know — and don’t know — about Merck’s new Covid-19 pill.

[Press release – not published yet] Merck announces oral antiviral Molnupiravir reduced the risk of hospitalization or death by approximately 50 Percent compared to placebo for patients with mild or moderate COVID-19.

Merck’s Covid-19 pill is great news but may not be a game-changer.

Video | A Pill For COVID? A Doctor Explains Molnupiravir.

Estudo pré-pós intervenção | A introdução de um sistema de alerta por mensagem de texto para avisar voluntários próximos a pacientes com parada cardíaca em casa foi associada a maior chance de sobrevida e alta hospitalar.

8 Mar, 2022 | 16:04h

Alert system-supported lay defibrillation and basic life-support for cardiac arrest at home – European Heart Journal

Editorial: Volunteer first responders for out-of-hospital cardiac arrest at home: the missing link for improved survival? – European Heart Journal

 

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Revisão | Estratégias terapêuticas para Pseudomonas aeruginosa multirresistente.

8 Mar, 2022 | 15:03h

Therapeutic Strategies for Emerging Multidrug-Resistant Pseudomonas aeruginosa – Infectious Diseases and Therapy

Conteúdos relacionados:

IDSA guidance and ESCMID guidelines: complementary approaches toward a care standard for MDR Gram-negative infections – Clinical Microbiology and Infection

European guidelines for the treatment of infections caused by Multidrug-resistant Gram-negative bacilli.

IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections.

Acinetobacter baumannii resistente a carbapeném: colonização, infecção e opções atuais de tratamento.

8 Mar, 2022 | 15:02h

Carbapenem-resistant Acinetobacter baumannii: Colonization, Infection and Current Treatment Options – Infectious Diseases and Therapy

Conteúdos relacionados:

IDSA guidance and ESCMID guidelines: complementary approaches toward a care standard for MDR Gram-negative infections – Clinical Microbiology and Infection

European guidelines for the treatment of infections caused by Multidrug-resistant Gram-negative bacilli.

IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections.

Estudo de coorte | Troponina I de alta sensibilidade após cirurgia cardíaca e mortalidade em 30 dias.

3 Mar, 2022 | 16:51h

High-Sensitivity Troponin I after Cardiac Surgery and 30-Day Mortality – New England Journal of Medicine (link para o resumo – $ para o texto completo)

Comentários:

Better assessment of risk from heart surgery results in better patient outcomes – McMaster University

NEJM study evaluates levels of HS Troponin after cardiac surgery and risk of death – MedicalResearch

Conteúdo relacionado: Retrospective cohort: Serial high-sensitivity cardiac troponin I after coronary artery bypass grafting may add prognostic information for post-operative decision-making.

 

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Estudo randomizado | Aspirina e heparina não fracionada aumentam o risco de hemorragia intracraniana sintomática em pacientes submetidos a tratamento endovascular de AVC isquêmico.

3 Mar, 2022 | 16:50h

Safety and efficacy of aspirin, unfractionated heparin, both, or neither during endovascular stroke treatment (MR CLEAN-MED): an open-label, multicentre, randomised controlled trial – The Lancet (link para o resumo – $ para o texto completo)

M-A | Uso de tocilizumabe e sarilumabe isoladamente ou em combinação com corticosteroides para Covid-19.

3 Mar, 2022 | 16:44h

Use of tocilizumab and sarilumab alone or in combination with corticosteroids for covid-19: systematic review and network meta-analysis – BMJ Medicine

Editorial: Treatment of severe covid-19 with interleukin 6 receptor inhibition – BMJ Medicine

Estudo relacionado (publicado recentemente): Mortality Rates Among Hospitalized Patients With COVID-19 Infection Treated With Tocilizumab and Corticosteroids: A Bayesian Reanalysis of a Previous Meta-analysis – JAMA Network Open

Estudo randomizado | Efeito da otimização de doses com base no monitoramento medicamentoso de piperacilina/tazobactam na disfunção de órgão relacionada a sepse em pacientes sépticos.

3 Mar, 2022 | 16:31h

Effect of therapeutic drug monitoring-based dose optimization of piperacillin/tazobactam on sepsis-related organ dysfunction in patients with sepsis: a randomized controlled trial – Intensive Care Medicine

 

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Estudo observacional sugere que a norepinefrina é uma opção melhor do que a epinefrina em pacientes com parada cardíaca e choque pós-ressuscitação.

3 Mar, 2022 | 16:29h

Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock – Intensive Care Medicine (link para o resumo – $ para o texto completo)

Conteúdo relacionado: Randomized Trial: Epinephrine vs Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction

 

 

M-A | Associação da administração de ácido tranexâmico com mortalidade e eventos tromboembólicos em pacientes com lesão traumática.

3 Mar, 2022 | 15:24h

Association of Tranexamic Acid Administration With Mortality and Thromboembolic Events in Patients With Traumatic Injury: A Systematic Review and Meta-analysis – JAMA Network Open

Conteúdos relacionados:

M-A: Prehospital Tranexamic Acid reduces mortality among bleeding trauma patients without increasing the risk of venous thromboembolism.

Tranexamic acid after traumatic brain injury: Exploratory analysis combining data from CRASH-2 and CRASH-3 trials suggests reduced mortality

Meta-analysis: Efficacy and safety of tranexamic acid in acute traumatic brain injury

Randomized trial: Tranexamic acid during prehospital transport in patients at risk for hemorrhage after injury

Randomized trial: Out-of-hospital tranexamic acid does not improve neurologic outcomes in patients with traumatic brain injury

Editorial: Is Tranexamic Acid Going to CRASH the Management of Traumatic Brain Injury?

Practice-Changing: Tranexamic Acid Reduces the Risk of Head Injury-related Death in Patients with Mild-to-moderate Head Injury

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