You searched for:"Luís Melo"
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Original Article
What changed between the peak and plateau periods of the first COVID-19 pandemic wave? A multicentric Portuguese cohort study in intensive care
Rev Bras Ter Intensiva. 2022;34(4):433-442
Abstract
Original ArticleWhat changed between the peak and plateau periods of the first COVID-19 pandemic wave? A multicentric Portuguese cohort study in intensive care
Rev Bras Ter Intensiva. 2022;34(4):433-442
DOI 10.5935/0103-507X.20210037-en
Views1ABSTRACT
Objective:
To analyze and compare COVID-19 patient characteristics, clinical management and outcomes between the peak and plateau periods of the first pandemic wave in Portugal.
Methods:
This was a multicentric ambispective cohort study including consecutive severe COVID-19 patients between March and August 2020 from 16 Portuguese intensive care units. The peak and plateau periods, respectively, weeks 10 – 16 and 17 – 34, were defined.
Results:
Five hundred forty-one adult patients with a median age of 65 [57 – 74] years, mostly male (71.2%), were included. There were no significant differences in median age (p = 0.3), Simplified Acute Physiology Score II (40 versus 39; p = 0.8), partial arterial oxygen pressure/fraction of inspired oxygen ratio (139 versus 136; p = 0.6), antibiotic therapy (57% versus 64%; p = 0.2) at admission, or 28-day mortality (24.4% versus 22.8%; p = 0.7) between the peak and plateau periods. During the peak period, patients had fewer comorbidities (1 [0 – 3] versus 2 [0 – 5]; p = 0.002) and presented a higher use of vasopressors (47% versus 36%; p < 0.001) and invasive mechanical ventilation (58.1 versus 49.2%; p < 0.001) at admission, prone positioning (45% versus 36%; p = 0.04), and hydroxychloroquine (59% versus 10%; p < 0.001) and lopinavir/ritonavir (41% versus 10%; p < 0.001) prescriptions. However, a greater use of high-flow nasal cannulas (5% versus 16%, p < 0.001) on admission, remdesivir (0.3% versus 15%; p < 0.001) and corticosteroid (29% versus 52%, p < 0.001) therapy, and a shorter ICU length of stay (12 days versus 8, p < 0.001) were observed during the plateau.
Conclusion:
There were significant changes in patient comorbidities, intensive care unit therapies and length of stay between the peak and plateau periods of the first COVID-19 wave.
Keywords:acute respiratory distress syndromeAdrenal cortex hormonesCoronavirus infectionsCOVID-19Critical care outcomesCritical illnessIntensive carePandemicsSARS-CoV-2See more -
Original Articles – Clinical Research
Gender and mortality in sepsis: do sex hormones impact the outcome?
Rev Bras Ter Intensiva. 2011;23(3):297-303
Abstract
Original Articles – Clinical ResearchGender and mortality in sepsis: do sex hormones impact the outcome?
Rev Bras Ter Intensiva. 2011;23(3):297-303
DOI 10.1590/S0103-507X2011000300007
Views0See moreOBJECTIVE: Comparative assessment of the mortality rates of two septic patients’ ages and/or gender subgroups, admitted to the intensive care unit of a university hospital. METHODS: From December 2005 to April 2008, from a total of 628 patients, 133 were admitted to the intensive care unit with sepsis and included into two age subgroups: (G1) 14 – 40 years old and (G2) more than 50 years old. Patients aged between 41 and 50 years old (n = 8) were excluded. Demographic data, prognostic indicators (APACHE II score, organ dysfunction and circulatory shock) and outcome (mortality) were analyzed. RESULTS: Of the G1 patients (n = 44), 27 were female (61.4%), and in G2 (n = 81), 40 were female (49.4%). For both groups, mean APACHE II scores, multi-organ dysfunction and progression to circulatory shock rates were not significantly different between female and male patients. For G1, overall mortality rate was lower in female than in male patients (P = 0.04), while for G2, the opposite trend was observed. CONCLUSIONS: In this sample, reproductive age female patients younger than 40 years old showed lower mortality rates compared with age-matched male patients; for patients older than 50 years old, male patients had lower mortality rates than female patients.
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis