Pulmonary mechanics profile of patients diagnosed with SARS-CoV-2 infection admitted and mechanically ventilated in an intensive care unit of a hospital in the interior of the Legal Amazon
DOI:
https://doi.org/10.33448/rsd-v10i14.22418Keywords:
Respiratory Mechanics; COVID-19; Respiratory distress syndrome; Respiration, artificial; Intensive Care Units.Abstract
This study aims to analyze the profile of pulmonary mechanics in patients who developed the severe form of COVID-19 and were hospitalized in an ICU in the southern interior of the state of Rondônia. This is a field study with a quantitative, cross-sectional descriptive, documentary, retrospective and prospective exploratory approach by analyzing secondary information from medical, nursing and physiotherapy records about demographic data, epidemiological, therapeutic, and clinical outcome of patients with positive RT-PCR for SARS-CoV-2 treated with MV within the first six months of pandemic care. Seventy samples were grouped, of which 57.14% were male with a mean age of 63.06 ± 14.95 years, height of 166.1 ± 9.09 cm and PBW of 60.54 ± 9.78 kg. The most common comorbidities were, SAH (61.43%), obesity (38.57%), DM (32.86%) and heart disease (15.71%). As for pulmonary mechanics, mean values of Total PEEP were found 8.24 + 0.58 cmH2O, Cst 30.42 + 10.07 ml/cmH2O, Pplateau 19.93 + 3.43 cmH2O, Rwa 13.56 + 5.44 cmH2O /Ls and SD of 11.82 + 3.47. It was observed in this sample that patients with ARDS secondary to COVID-19 had pulmonary mechanics similar to classic ARDS, with no differentiation of phenotypes or pattern in mechanics that would indicate a probability of clinical outcome (discharge/death) among patients.
References
Bernheim, A., Mei, X., Huang, M., Yang, Y., Fayad, ZA, Zhang, N., ... & Chung, M. (2020). Achados de TC de tórax na doença coronavírus-19 (COVID-19): relação com a duração da infecção. Radiology, 200463.
Botta, M., Tsonas, A. M., Pillay, J., Boers, L. S., Algera, A. G., Bos, L. D., ... e van Zanten, A. R., (2021). Gerenciamento da ventilação e resultados clínicos em pacientes ventilados invasivamente com COVID-19 (PRoVENT-COVID): um estudo de coorte nacional, multicêntrico e observacional. The lancet Respiratory medicine, 9 (2), 139-148.
Brasil, MS., (2020). Programa de apoio de desenvolvimento do SUS. https://hospitais.proadi-sus.org.br/covid19/conheca-as-iniciativas-da-forca-tarefa/21/impacto-mr.
Croda, J., Oliveira, WKD, Frutuoso, RL, Mandetta, LH, Baia-da-Silva, DC, Brito-Sousa, JD, ... & Lacerda, MVG (2020). COVID-19 no Brasil: vantagens de um sistema único de saúde socializado e preparação para contenção de casos. Revista da Sociedade Brasileira de Medicina Tropical, 53.
Cummings M. J, Baldwin M. R, Abrams D. et al., (2020) Epidemiologia, curso clínico e resultados de adultos gravemente enfermos com COVID-19 na cidade de Nova York: um estudo de coorte prospectivo. The Lancet (edição britânica) 395: 1763–1770.
Estrela, C. (2018). Metodologia Científica: Ciência, Ensino, Pesquisa. Editora Artes Médicas.
Ferrando, C., Suarez-Sipmann, F., Mellado-Artigas, R., Hernández, M., Gea, A., Arruti, E., ... & Villar, J. (2020). Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS. Intensive care medicine, 46(12), 2200-2211.
Gattinoni, L., Chiumello, D. & Rossi, S., (2020a). COVID-19 pneumonia: ARDS or not?. Crit Care 24, 154.
Gattinoni, L., Chiumello, D., Caironi, P. et al., (2020b). Pneumonia COVID-19: diferentes tratamentos respiratórios para diferentes fenótipos? Intensive Care Med 46, 1099-1102.
Gattinoni, L., Coppola, S., Cressoni, M., Busana, M., Rossi, S., & Chiumello, D. (2020c). COVID-19 não leva a uma síndrome de dificuldade respiratória aguda “típica”. Jornal americano de medicina respiratória e de cuidados intensivos, 201 (10), 1299-1300.
Goligher, E. C., Ranieri, V. M., & Slutsky, A. S., (2021). A pneumonia COVID-19 grave é uma forma típica ou atípica de SDRA? E isso importa? Intensive Care Med 47, 83–85.
Goyal, P., Choi, J. J., Pinheiro, L. C., Schenck, E. J., Chen, R., Jabri, A., ... & Safford, M. M. (2020). Clinical characteristics of Covid-19 in New York city. New England Journal of medicine, 382(24), 2372-2374.
Grasselli, G., Zangrillo, A., Zanella, A., Antonelli, M., Cabrini, L., Castelli, A., ... & Zoia, E. (2020). Características basais e desfechos de 1.591 pacientes infectados com SARS-CoV-2 internados em UTIs da região da Lombardia, Itália. Jama , 323 (16), 1574-1581.
Morsch, K. T., Leguisamo, C. P., Camargo, M. D., Coronel, C. C., Mattos, W., Ortiz, L. D., & Lima, G. G. D. (2009). Perfil ventilatório dos pacientes submetidos a cirurgia de revascularização do miocárdio. Brazilian Journal of Cardiovascular Surgery, 24, 180-187.
Noronha, K. V. M. D. S., Guedes, G. R., Turra, C. M., Andrade, M. V., Botega, L., Nogueira, D., ... & Ferreira, M. F. (2020). Pandemia por COVID-19 no Brasil: análise da demanda e da oferta de leitos hospitalares e equipamentos de ventilação assistida segundo diferentes cenários. Cadernos de Saúde Pública, 36, e00115320.
Sarmento, G. J., Papa, D. C., & Raimundo, R. D. (2011). Princípios e práticas de ventilação mecânica em pediatria e neonatologia. PRINCÍPIOS, 8, 12.
Schenck, E. J., Hoffman, K., Goyal, P., Choi, J., Torres, L., Rajwani, K., ... & Berlin, D. A. (2020). Respiratory mechanics and gas exchange in COVID-19–associated respiratory failure. Annals of the American Thoracic Society, 17(9), 1158-1161.
Tallo, F. S., Vendrame, L. S., Lopes, R. D., & Lopes, A. C. (2013). Ventilação mecânica invasiva na sala de emergência: uma revisão para o clínico. Rev Bras Clin Med. São Paulo, jan-mar, 11(1), 48-54.
Tan, W., Zhao, X., Ma, X., Wang, W., Niu, P., Xu, W., ... & Wu, G. (2020). Um novo genoma de coronavírus identificado em um grupo de casos de pneumonia - Wuhan, China, 2019-2020. China CDC semanal, 2 (4), 61-62.
Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., ... & Tan, W. (2019). T. Research; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 727-733.
Ziehr, D. R., et al., (2020). Fisiopatologia respiratória de pacientes ventilados mecanicamente com COVID-19: Um estudo de coorte. Sou. J. Respir. Crit. Care Med. 201, 1560–1564.
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