Acesso livre
Acesso livre

Terapia Intensiva

Estudo randomizado por cluster | Intervenção de gestão de antibióticos reduziu, de modo seguro, o uso de antibióticos de amplo espectro em pacientes internados com pneumonia adquirida na comunidade moderadamente grave.

13 Out, 2021 | 12:28h

Narrow-spectrum antibiotics for community-acquired pneumonia in Dutch adults (CAP-PACT): a cross-sectional, stepped-wedge, cluster-randomised, non-inferiority, antimicrobial stewardship intervention trial – The Lancet Infectious Diseases (link para o resumo – $ para o texto completo)

Estudo randomizado | Dose terapêutica de heparina se mostrou superior à dose profilática ou à dose intermediária para tromboprofilaxia em pacientes de alto risco internados com COVID-19.

12 Out, 2021 | 11:22h

Efficacy and Safety of Therapeutic-Dose Heparin vs Standard Prophylactic or Intermediate-Dose Heparins for Thromboprophylaxis in High-risk Hospitalized Patients With COVID-19: The HEP-COVID Randomized Clinical Trial – JAMA Internal Medicine

Comentário convidado: Anticoagulant Therapy in Patients Hospitalized With COVID-19 – JAMA Internal Medicine

Estudos relacionados (alguns resultados conflitantes)

Another meta-analysis suggests standard-dose prophylactic anticoagulation is the best option for patients hospitalized with Covid-19.

M-A: Safety and efficacy of different prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19 – According to this analysis, standard-dose prophylactic anticoagulation should be the standard of care for hospitalized patients with COVID-19 who do not have an indication for therapeutic anticoagulation, irrespective of disease severity.

RCT: In noncritically ill patients hospitalized with Covid-19, therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge compared with usual-care thromboprophylaxis.

RCT: In critically ill patients with Covid-19, therapeutic anticoagulation with heparin did not result in improved outcomes compared to usual-care pharmacologic thromboprophylaxis.

RCT: In patients hospitalized with Covid-19 with elevated D-Dimer, a full-dose anticoagulation strategy based on rivaroxaban (full-dose heparins in unstable patients) + rivaroxaban to day 30 was not better than prophylactic anticoagulation and increased bleeding risk.

 

Comentário no Twitter

 

Estudo mostra risco aumentado de síndrome de Guillain-Barré após vacina da J&J; a razão de taxas foi de 4,18 para uma janela de 42 dias.

8 Out, 2021 | 12:27h

Association of Receipt of the Ad26.COV2.S COVID-19 Vaccine With Presumptive Guillain-Barré Syndrome, February-July 2021 – JAMA

 

Comentário no Twitter

 

Estudo randomizado | Drenagem imediata não melhora os desfechos em comparação à intervenção tardia em pacientes com pancreatite necrotizante infectada.

8 Out, 2021 | 11:52h

Immediate versus Postponed Intervention for Infected Necrotizing Pancreatitis – New England Journal of Medicine

Estudo randomizado SILENCE | Em pacientes em fim de vida, o butilbrometo de escopolamina subcutâneo profilático reduz a ocorrência de estertor da morte (respiração ruidosa causada pelo muco presente no trato respiratório superior).

8 Out, 2021 | 11:12h

Effect of Prophylactic Subcutaneous Scopolamine Butylbromide on Death Rattle in Patients at the End of LifeThe SILENCE Randomized Clinical Trial – JAMA (gratuito por tempo limitado)

Editorial: Preventing Death Rattle With Prophylactic Subcutaneous Scopolamine Butylbromide – JAMA (gratuito por tempo limitado)

Entrevista com os autores: Scopolamine Butylbromide for Preventing End-of-Life Death Rattle – JAMA

 

Comentário no Twitter

 

Estudo randomizado | Estratégia ativa para o diagnóstico de embolia pulmonar não melhorou o desfecho em pacientes hospitalizados com exacerbação de DPOC.

8 Out, 2021 | 11:07h

Effect of a Pulmonary Embolism Diagnostic Strategy on Clinical Outcomes in Patients Hospitalized for COPD Exacerbation: A Randomized Clinical Trial – JAMA (gratuito por tempo limitado)

 

Comentário no Twitter

 

Estudo randomizado | Mais um estudo mostra que plasma convalescente não melhora os desfechos em pacientes criticamente doentes com Covid-19.

5 Out, 2021 | 11:32h

Effect of Convalescent Plasma on Organ Support–Free Days in Critically Ill Patients With COVID-19 A Randomized Clinical Trial – JAMA

Commentary: Convalescent plasma futile as treatment for critically ill COVID-19 patients, study finds – University of Pittsburgh

Conteúdos relacionados:

RCT: Convalescent plasma does not improve outcomes and may be harmful to hospitalized patients with COVID-19.

NIH study shows no significant benefit of convalescent plasma for COVID-19 outpatients with early symptoms.

M-A: Convalescent plasma is safe but does not improve outcomes in the treatment of COVID-19.

RECOVERY Trial: No benefit from convalescent plasma in patients admitted to hospital with COVID-19.

Pílula da Merck contra Covid-19 é uma ótima notícia, mas pode não ser uma grande mudança.

5 Out, 2021 | 11:28h

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

Vídeo | Uma pílula para COVID? Um médico explica o molnupiravir.

5 Out, 2021 | 11:26h

A Pill For COVID? | A Doctor Explains Molnupiravir – ZDoggMD

Diretriz Científica AHA | Diagnóstico e tratamento de pacientes com lesão miocárdica após cirurgia não cardíaca.

5 Out, 2021 | 11:25h

Diagnosis and Management of Patients With Myocardial Injury After Noncardiac Surgery: A Scientific Statement From the American Heart Association – Circulation

Comunicado de imprensa: 1 in 5 adults has high levels of heart enzymes after any surgery, monitoring advised – American Heart Association

Comentário: AHA: More Screening Needed to Catch Myocardial Injury After Noncardiac Surgery – TCTMD

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