EFEITOS DAS BEBIDAS ENERGÉTICAS NA SAÚDE CARDÍACA DE JOVENS ADULTOS

The increasing consumption of energy drinks among young adults has raised concerns due to potential cardiac health risks. This study reviewed the literature to investigate these impacts, considering that this age group is in a crucial phase for maintaining cardiovascular health. Using the PubMed, Scopus, and Web of Science databases, studies addressing the cardiovascular effects of energy drinks, such as increased heart rate and blood pressure, as well as adverse cardiac events, were selected. The main findings indicate that components such as caffeine and taurine have significant effects on the cardiovascular system. Caffeine can increase blood pressure and heart rate, while taurine can exacerbate these effects, especially at high doses. The review highlights the need for greater awareness of the risks of regular consumption of these drinks and suggests the implementation of clearer guidelines and stricter regulations. This study contributes to a better understanding of the risks associated with energy drink consumption, providing a solid basis for future research and public health policies. Promoting safe consumption practices and establishing effective regulations are crucial to protecting the cardiac health of young adults and preventing future complications.O crescente consumo de bebidas energéticas entre jovens adultos tem despertado preocupações devido aos potenciais riscos à saúde cardíaca. Este estudo revisou a literatura para investigar esses impactos, considerando que essa faixa etária está em uma fase crucial para a manutenção da saúde cardiovascular. Utilizando as bases de dados PubMed, Scopus e Web of Science, foram selecionados estudos que abordaram os efeitos cardiovasculares das bebidas energéticas, como aumento da frequência cardíaca e pressão arterial, bem como eventos cardíacos adversos. Os principais achados indicam que componentes como cafeína e taurina têm efeitos significativos no sistema cardiovascular. A cafeína pode aumentar a pressão arterial e a frequência cardíaca, enquanto a taurina pode exacerbar esses efeitos, especialmente em doses elevadas. A revisão destaca a necessidade de maior conscientização sobre os riscos do consumo regular dessas bebidas e sugere a implementação de diretrizes e regulamentações mais rígidas. Este estudo contribui para uma melhor compreensão dos riscos associados ao consumo de bebidas energéticas, fornecendo uma base sólida para futuras investigações e políticas de saúde pública. A promoção de práticas de consumo seguro e a elaboração de regulamentações eficazes são cruciais para proteger a saúde cardíaca dos jovens adultos e prevenir complicações futuras

Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial

IMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022