Acesso livre
Acesso livre

Terapia Intensiva

Estudo randomizado | Em pacientes críticos hospitalizados com Covid-19, anticoagulação em dose terapêutica com heparina não resultou em melhores desfechos em comparação com a tromboprofilaxia farmacológica usual.

5 Ago, 2021 | 12:00h

Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19 – New England Journal of Medicine

Editorial: Surviving Covid-19 with Heparin?

Comentários:

Full-dose blood thinners reduce the need for organ support in moderately ill COVID-19 patients, but not in critically ill patients – National Institutes of Health

Therapeutic-Dose Heparin in COVID-19: Who Benefits, Who Doesn’t – TCTMD

 

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Miocardite e pericardite após vacinação contra COVID-19.

5 Ago, 2021 | 11:53h

Myocarditis and Pericarditis After Vaccination for COVID-19 – JAMA

Conteúdos relacionados:

Analysis finds benefits of COVID-19 vaccination outweigh risks of rare cases of myocarditis.

CDC: Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients – “Continued use of mRNA COVID-19 vaccines in all recommended age groups will prevent morbidity and mortality from COVID-19 that far exceed the number of cases of myocarditis expected”.

Case Series: Myocarditis following immunization with mRNA COVID-19 vaccines.

CDC: mRNA vaccines are likely linked to cases of myocarditis and pericarditis – 1,226 cases of myocarditis or pericarditis have been reported mostly in people under 30.

Estudo randomizado | Desfechos similares entre milrinona e dobutamina no tratamento do choque cardiogênico.

5 Ago, 2021 | 11:40h

Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock – New England Journal of Medicine (link para o resumo – $ para o texto completo)

Resumo visual: Milrinone vs. Dobutamine in Cardiogenic Shock

Comentário: Inotrope Showdown Leaves No Winner in Cardiogenic Shock – MedPage Today (link para o resumo – $ para o texto completo)

Posicionamento Científico | Abordagem perioperatória de pacientes cirúrgicos pós-COVID-19.

4 Ago, 2021 | 12:35h

Perioperative management of post-COVID-19 surgical patients: Indian Society of Anaesthesiologists (ISA National) Advisory and Position Statement – Indian Journal of Anaesthesia

Conteúdos relacionados:

Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery

Study from 116 countries suggests surgery should be delayed for at least seven weeks following a COVID-19 diagnosis to reduce mortality risk

Cohort study: Postoperative in-hospital mortality of patients with COVID-19 infection was more than double that in patients without COVID-19

WSES Position Paper: The management of surgical patients in the emergency setting during COVID-19 pandemic

Preparing previously COVID-19-positive patients for elective surgery: A framework for preoperative evaluation

 

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Gestão de antimicrobianos na UTI em tempos de COVID.

4 Ago, 2021 | 12:31h

Antimicrobial stewardship in the ICU in COVID times: the known unknowns – International Journal of Antimicrobial Agents

Conteúdos relacionados:

IDSA Updated Covid-19 Guidance: Co-Infection and Antimicrobial Stewardship – “bacterial coinfections with SARS-CoV-2 infection are relatively infrequent (likely occurring in less than 10% of hospitalized COVID-19 patients)”.

Antimicrobial stewardship in ICUs during the COVID-19 pandemic: back to the 90s?

Another study shows a high frequency of antibiotic use among patients hospitalized with Covid-19 (85.2%), despite low rates of confirmed secondary bacterial infections.

Too many COVID-19 patients get unneeded ‘just in case’ antibiotics

Pneumomediastino espontâneo em pacientes diagnosticados com Covid-19: uma série de casos com revisão da literatura.

4 Ago, 2021 | 12:29h

Spontaneous Pneumomediastinum in Patients Diagnosed with COVID-19: a Case Series with Review of Literature – Academic Radiology

Recomendações de prática clínica sobre a abordagem da parada cardíaca perioperatória.

4 Ago, 2021 | 12:20h

Clinical practice recommendations on the management of perioperative cardiac arrest: A report from the PERIOPCA Consortium – Critical Care

Atualização 2021 sobre diagnóstico e tratamento de síndromes coronarianas agudas no perioperatório.

3 Ago, 2021 | 11:16h

2021 Update in the Diagnosis and Management of Acute Coronary Syndromes For the Perioperative Clinician – Journal of Cardiothoracic and Vascular Anesthesia

 

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O que todo intensivista deveria saber sobre o tocilizumabe.

2 Ago, 2021 | 19:11h

What every intensivist should know about Tocilizumab – Critical Care

Conteúdos relacionados:

Tocilizumab in COVID-19 therapy: who benefits, and how?

A living WHO guideline on drugs for covid-19 – interleukin-6 receptor blockers are now recommended for patients with severe or critical covid-19.

M-A: Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19 – “The 4% absolute risk reduction in mortality from 25% to 21% with IL-6 inhibition added to glucocorticoids may not translate to patients with a lower baseline mortality risk and likely do not justify the additional expense and risk for toxicities for patients hospitalized with modest oxygen requirements and a stable clinical course (from editorial)”.

RECOVERY trial: In hospitalized COVID-19 patients with hypoxia and systemic inflammation (C-reactive protein ≥75 mg/L), tocilizumab improved survival and other clinical outcomes

Secondary analysis of RCT finds Tocilizumab was beneficial to patients hospitalized with Covid-19 if CRP levels were greater than 15.0 mg/dL, but not if CRP levels were 15.0 mg/dL or less.

M-A: Tocilizumab in COVID-19 – “For hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required”.

Estudo observacional | Balanço hídrico positivo está associado a piores desfechos em pacientes criticamente doentes com lesão cerebral traumática.

2 Ago, 2021 | 18:40h

Fluid balance and outcome in critically ill patients with traumatic brain injury (CENTER-TBI and OzENTER-TBI): a prospective, multicentre, comparative effectiveness study – The Lancet Neurology (link para o resumo – $ para o texto completo)

Comentário: Traumatic Brain Injury: Fluid Overload Tied to Higher Mortality in ICU Patients – Physician’s Weekly

 

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