Emergências e Terapia Intensiva

Estudo randomizado | Em adultos com doença crítica, o uso de solução balanceada de multieletrólitos não reduziu o risco de morte ou lesão renal aguda em comparação à solução salina padrão.

20 Jan, 2022 | 22:05h

Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults – New England Journal of Medicine (link para o resumo – $ para o texto completo)

Comentário: Australian study set to guide the treatment of critically ill patients worldwide – George Institute for Global Health

Conteúdos relacionados:

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.

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

Comentário no Twitter

Trial of critically ill patients compared balanced multielectrolyte solution (BMES) with saline as fluid therapy in the ICU. There was no evidence that the risk of death or acute kidney injury was lower with the use of BMES than with saline. https://t.co/bmlg4BYaw8 pic.twitter.com/OlKGOM0Dmm

— NEJM (@NEJM) January 18, 2022

Diretrizes de prática clínica para o monitoramento do tratamento medicamentoso com teicoplanina.

20 Jan, 2022 | 21:53h

Clinical practice guidelines for therapeutic drug monitoring of teicoplanin: a consensus review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring – Journal of Antimicrobial Chemotherapy

M-A | Avaliação de intervenções para reduzir a prescrição de opioides para pacientes após alta do departamento de emergência.

20 Jan, 2022 | 21:40h

Evaluation of Interventions to Reduce Opioid Prescribing for Patients Discharged From the Emergency Department: A Systematic Review and Meta-analysis – JAMA Network Open

Comentário convidado: Optimizing Opioid Prescriptions for Patients in the Emergency Department—How Much Is Almost Never? – JAMA Network Open

Comentário no Twitter

This meta-analysis of 63 studies showed that most interventions were able to reduce opioid prescription rates but not the prescribed opioid quantity for ED-discharged patients. Almost no data on patients-centered outcomes were assessed in these studies. https://t.co/Cd1D7EjCkI

— JAMA Network Open (@JAMANetworkOpen) January 13, 2022

Evidências atualizadas da Cochrane sobre COVID-19.

20 Jan, 2022 | 21:33h

COVID-19 evidence: a Cochrane round-up – Cochrane Library

Diretriz ACP | Diagnóstico e tratamento da diverticulite colônica aguda de lado esquerdo.

20 Jan, 2022 | 21:09h

Diagnosis and Management of Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians – Annals of Internal Medicine

Diretriz relacionada: Colonoscopy for Diagnostic Evaluation and Interventions to Prevent Recurrence After Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians – Annals of Internal Medicine

Revisões sistemáticas relacionadas:

Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

Evaluation and Management After Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

Resumo em vídeo: Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

Comunicado de imprensa: ACP releases two new clinical guidelines on the diagnosis and management of diverticulitis – American College of Physicians

Debate Pró-Con | Medida de troponina cardíaca como parte do seguimento rotineiro de dano miocárdico após cirurgia não cardíaca.

20 Jan, 2022 | 21:07h

Pro-Con Debate: Cardiac Troponin Measurement as Part of Routine Follow-up of Myocardial Damage Following Noncardiac Surgery – Anesthesia & Analgesia

Estudo randomizado por cluster | Banho antisséptico com compressas impregnadas de clorexidina 2% e lavagem com luvas com octenidina 0,08% não foram efetivos na prevenção de infecções de corrente sanguínea associadas a cateter central em pacientes de terapia intensiva.

20 Jan, 2022 | 20:41h

Effect of antiseptic bathing with chlorhexidine or octenidine on central-line associated bloodstream infections in intensive care patients: a cluster-randomised controlled trial – Clinical Microbiology and Infection

OMS recomenda dois novos medicamentos (baricitinibe e sotrovimabe) para tratar COVID-19.

20 Jan, 2022 | 20:20h

Comunicado de imprensa: WHO recommends two new drugs to treat COVID-19 – World Health Organization

Infográfico com recomendações atualizadas: A living WHO guideline on drugs for covid-19 – The BMJ

Comentários:

WHO Recommends Two New COVID-19 Treatments – Cost and Availability Likely Barriers – Health Policy Watch

Expert reaction to WHO recommending two drugs, sotrovimab and baricitinib, to treat patients with COVID-19 – Science Media Centre

Comentário no Twitter (fio – clique para saber mais)

WHO has also conditionally recommended the use of sotrovimab for treating mild or moderate #COVID19 in patients who are at high risk of hospitalization: patients who are older, immunocompromised, with underlying conditions & those unvaccinated https://t.co/UAc21Wgxbl https://t.co/Z39mSKrOv5

— World Health Organization (WHO) (@WHO) January 14, 2022

Ponto de vista | Tratamentos para COVID-19 para pacientes não internados.

20 Jan, 2022 | 20:11h

COVID-19 Therapeutics for Nonhospitalized Patients – JAMA

Editorial: Realizing the Potential of Anti–SARS-CoV-2 Monoclonal Antibodies for COVID-19 Management – JAMA

Diretrizes para a provisão de terapia de suporte nutricional no adulto com doença crítica.

20 Jan, 2022 | 20:01h

Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition – Journal of Parenteral and Enteral Nutrition