You searched for:"Suzana Margareth Lobo"
We found (18) results for your search.-
Original Article
Myocardial injury and cardiovascular complications in COVID-19: a cohort study in severe and critical patients
Rev Bras Ter Intensiva. 2022;34(4):443-451
Abstract
Original ArticleMyocardial injury and cardiovascular complications in COVID-19: a cohort study in severe and critical patients
Rev Bras Ter Intensiva. 2022;34(4):443-451
DOI 10.5935/0103-507X.20220440-en
Views1ABSTRACT
Objective:
To characterize myocardial injury and cardiovascular complications and their predictors in severe and critical COVID-19 patients admitted to the intensive care unit.
Methods:
This was an observational cohort study of severe and critical COVID-19 patients admitted to the intensive care unit. Myocardial injury was defined as blood levels of cardiac troponin above the 99th percentile upper reference limit. Cardiovascular events considered were the composite of deep vein thrombosis, pulmonary embolism, stroke, myocardial infarction, acute limb ischemia, mesenteric ischemia, heart failure and arrhythmia. Univariate and multivariate logistic regression or Cox proportional hazard models were used to determine predictors of myocardial injury.
Results:
Of 567 patients with severe and critical COVID-19 admitted to the intensive care unit, 273 (48.1%) had myocardial injury. Of the 374 patients with critical COVID-19, 86.1% had myocardial injury, and also showed more organ dysfunction and higher 28-day mortality (56.6% versus 27.1%, p < 0.001). Advanced age, arterial hypertension and immune modulator use were predictors of myocardial injury. Cardiovascular complications occurred in 19.9% of patients with severe and critical COVID-19 admitted to the intensive care unit, with most events occurring in patients with myocardial injury (28.2% versus 12.2%, p < 0.001). The occurrence of an early cardiovascular event during intensive care unit stay was associated with higher 28-day mortality compared with late or no events (57.1% versus 34% versus 41.8%, p = 0.01).
Conclusion:
Myocardial injury and cardiovascular complications were commonly found in patients with severe and critical forms of COVID-19 admitted to the intensive care unit, and both were associated with increased mortality in these patients.
Keywords:Cardiovascular complicationsCoronavirus infectionsCOVID-19Critical careMyocardial injuryMyocarditisSARS-CoV-2See more -
Commentary
Challenges of the coronavirus pandemic for Brazilian intensivists: present and future
Rev Bras Ter Intensiva. 2021;33(3):339-340
Abstract
CommentaryChallenges of the coronavirus pandemic for Brazilian intensivists: present and future
Rev Bras Ter Intensiva. 2021;33(3):339-340
DOI 10.5935/0103-507X.20210052
Views0CommentsThe first cases of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) in Brazil was reported in February 2020. Despite the extensive reach of the Brazilian public health system and its impressive capillarity capacity throughout the entire country, not a single county or community was spared from coronavirus disease 2019 (COVID-19). The mitigation phase of the […]See more -
Special Article
Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the Associação de Medicina Intensiva Brasileira, Associação Brasileira de Transplantes de Órgãos, Brazilian Research in Critical Care Network, and the General Coordination of the National Transplant System
Rev Bras Ter Intensiva. 2021;33(1):1-11
Abstract
Special ArticleBrazilian guidelines for the management of brain-dead potential organ donors. The task force of the Associação de Medicina Intensiva Brasileira, Associação Brasileira de Transplantes de Órgãos, Brazilian Research in Critical Care Network, and the General Coordination of the National Transplant System
Rev Bras Ter Intensiva. 2021;33(1):1-11
DOI 10.5935/0103-507X.20210001
Views5See moreAbstract
Objective:
To contribute to updating the recommendations for brain-dead potential organ donor management.
Methods:
A group of 27 experts, including intensivists, transplant coordinators, transplant surgeons, and epidemiologists, answered questions related to the following topics were divided into mechanical ventilation, hemodynamics, endocrine-metabolic management, infection, body temperature, blood transfusion, and checklists use. The outcomes considered were cardiac arrests, number of organs removed or transplanted as well as function / survival of transplanted organs. The quality of evidence of the recommendations was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system to classify the recommendations.
Results:
A total of 19 recommendations were drawn from the expert panel. Of these, 7 were classified as strong, 11 as weak and 1 was considered a good clinical practice.
Conclusion:
Despite the agreement among panel members on most recommendations, the grade of recommendation was mostly weak.
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Commentary
Choosing Wisely in intensive care medicine
Rev Bras Ter Intensiva. 2020;32(1):11-13
Abstract
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Commentary
Mortality due to sepsis in Brazil in a real scenario: the Brazilian ICUs project
Rev Bras Ter Intensiva. 2019;31(1):1-4
Abstract
CommentaryMortality due to sepsis in Brazil in a real scenario: the Brazilian ICUs project
Rev Bras Ter Intensiva. 2019;31(1):1-4
DOI 10.5935/0103-507X.20190008
Views1Worldwide, the number of sepsis patients per year is estimated at 15 to 17 million, contributing to more than 5 million deaths annually.(–) In Brazil, recent publications have indicated an increase in the number of cases of this syndrome in late years.() Many factors have contributed to this trend, such as population growth and rising […]See more -
Original Articles – Clinical Research
Serum C-reactive protein concentrations in early abdominal and pulmonary sepsis
Rev Bras Ter Intensiva. 2013;25(1):6-11
Abstract
Original Articles – Clinical ResearchSerum C-reactive protein concentrations in early abdominal and pulmonary sepsis
Rev Bras Ter Intensiva. 2013;25(1):6-11
DOI 10.1590/S0103-507X2013000100003
Views0See moreOBJECTIVES: To evaluate the C-reactive protein serum levels in patients with pulmonary and abdominal sepsis during the first five days of sepsis progression. METHODS: The present investigation was a retrospective cohort study conducted at the university hospital with 345 patients who were admitted to the intensive care unit and diagnosed with sepsis of pulmonary or abdominal origin. Serum C-reactive protein concentrations were measured by the turbidimetric immunoassay. For analysis of C-reactive protein, day 1 was defined as the day on which the patient was clinically diagnosed with sepsis. RESULTS: Thirty-four patients with sepsis (9.8%), 114 patients with severe sepsis (33.0%), and 197 patients with septic shock (57.2%) were evaluated. The age of the patients was 56.4±19.8 years. The serum C-reactive protein concentrations were higher on the day of sepsis diagnosis in the group with abdominal infection compared with the group with pulmonary sepsis (17.8±10.1 mg/dL versus 14.9±11.1 mg/dL, p=0.025) and remained significantly higher during the first five days of sepsis progression. CONCLUSION: The serum C-reactive protein concentrations were significantly higher in the patients with abdominal sepsis compared with the patients with pulmonary sepsis during the first five days of sepsis progression.
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Original Articles – Clinical Research
The use of 2% chlorhexidine gel and toothbrushing for oral hygiene of patients receiving mechanical ventilation: effects on ventilator-associated pneumonia
Rev Bras Ter Intensiva. 2012;24(4):369-374
Abstract
Original Articles – Clinical ResearchThe use of 2% chlorhexidine gel and toothbrushing for oral hygiene of patients receiving mechanical ventilation: effects on ventilator-associated pneumonia
Rev Bras Ter Intensiva. 2012;24(4):369-374
DOI 10.1590/S0103-507X2012000400013
Views0OBJECTIVE: To evaluate the effects of oral chlorhexidine hygiene with toothbrushing on the rate of ventilator-associated pneumonia in a mixed population of critically ill patients under prolonged mechanical ventilation. METHODS: Prospective, randomized, and placebo-controlled pilot study. Patients who were receiving mechanical ventilation, had been admitted less than 24 hours prior, and were anticipated to require mechanical ventilation for more than 72 hours were included in the study. The patients were randomly divided into one of the following groups: chlorhexidine hygiene with toothbrushing or a placebo group (gel with the same color and consistency and toothbrushing). RESULTS: The planned interim analysis was conducted using 52 patients, and the study was terminated prematurely. In total, 28 patients were included in the chlorhexidine / toothbrushing group, and 24 patients were included in the placebo group. Ventilator-associated pneumonia occurred in 45.8% of the placebo group and in 64.3% of the chlorhexidine hygiene with toothbrushing group (RR=1.4; 95% CI=0.83-2.34; p=0.29). CONCLUSION: Because the study was terminated due to futility, it was not possible to evaluate the impact of oral hygiene using 2% chlorhexidine and toothbrushing on the incidence of ventilator-associated pneumonia in this heterogeneous population of critical patients receiving long-term mechanical ventilation, and no beneficial effect was observed for this intervention.
Keywords:ChlorhexidineIntensive care unitsManual brushingOral hygienePlacebosPneumonia, ventilator-associatedSee more
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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