Gestão do Centro de Triagem do Coronavírus em Macaé: da implantação aos resultados

Cross-sectional study that aims to: describe the experience of the city of Macaé in implementing the Coronavirus Screening Center; describe the nurse's role in implementing the CTC; present the profile of COVID-19 in the municipality of Macaé. Conducted from the analysis of notifications from the Information System for the Epidemiological Surveillance of Influenza and e-SUS VE in the period between March and July 2020. The data were tabulated and analyzed with the statistical resources of Microsoft Excel and Tabwin. The main symptoms identified were cough and fever and the number of cases was higher in males. The predominant age was between 30 and 49 years. It is concluded that the CTC became a municipal reference in the reception and monitoring of cases of COVID-19 and that nursing had a fundamental role in the organization of this service, in addition to appearing as the main category notified from the consultations.Estudo transversal que tem como objetivos: descrever a experiência do município de Macaé na implantação do Centro de Triagem do Coronavírus; descrever o papel do enfermeiro na implantação do CTC; apresentar o perfil da COVID-19 no município de Macaé. Realizado a partir da análise das notificações do Sistema de Informação da Vigilância Epidemiológica da Gripe e e-SUS VE no período entre março e julho de 2020. Os dados foram tabulados e analisados com os recursos estatísticos do Microsoft Excel e do Tabwin. Os principais sintomas identificados foram tosse e febre e o número de casos foi maior no sexo masculino. A idade predominante foi entre 30 e 49 anos. Conclui-se que o CTC se tornou referência municipal no acolhimento e acompanhamento dos casos de COVID-19 e que a enfermagem teve papel fundamental na organização desse serviço, além de surgir como principal categoria notificada a partir dos atendimentos

Gestão do Centro de Triagem do Coronavírus em Macaé: da implantação aos resultados

Cross-sectional study that aims to: describe the experience of the city of Macaé in implementing the Coronavirus Screening Center; describe the nurse's role in implementing the CTC; present the profile of COVID-19 in the municipality of Macaé. Conducted from the analysis of notifications from the Information System for the Epidemiological Surveillance of Influenza and e-SUS VE in the period between March and July 2020. The data were tabulated and analyzed with the statistical resources of Microsoft Excel and Tabwin. The main symptoms identified were cough and fever and the number of cases was higher in males. The predominant age was between 30 and 49 years. It is concluded that the CTC became a municipal reference in the reception and monitoring of cases of COVID-19 and that nursing had a fundamental role in the organization of this service, in addition to appearing as the main category notified from the consultations.Estudo transversal que tem como objetivos: descrever a experiência do município de Macaé na implantação do Centro de Triagem do Coronavírus; descrever o papel do enfermeiro na implantação do CTC; apresentar o perfil da COVID-19 no município de Macaé. Realizado a partir da análise das notificações do Sistema de Informação da Vigilância Epidemiológica da Gripe e e-SUS VE no período entre março e julho de 2020. Os dados foram tabulados e analisados com os recursos estatísticos do Microsoft Excel e do Tabwin. Os principais sintomas identificados foram tosse e febre e o número de casos foi maior no sexo masculino. A idade predominante foi entre 30 e 49 anos. Conclui-se que o CTC se tornou referência municipal no acolhimento e acompanhamento dos casos de COVID-19 e que a enfermagem teve papel fundamental na organização desse serviço, além de surgir como principal categoria notificada a partir dos atendimentos

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