Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista JRG de Estudos Acadêmicos |
Texto Completo: | http://revistajrg.com/index.php/jrg/article/view/658 |
Resumo: | Introduction: Pharmacotherapeutic treatment in the context of Covid-19 presented complex challenges for multidisciplinary teams. Medicines played a very important role in the recovery of the health of patients with covid-19 disease, among the most prescribed classes are sedatives, benzodiazepines, analgesics, neuromuscular blockers, antipsychotics and antidepressants, administered for induction , maintenance and/or withdrawal of invasive mechanical ventilation (IMV). These procedures, in addition to fulfilling the anxiolytic, hypnotic and amnestic needs of these patients, aimed to alleviate the discomfort associated with orotracheal intubation and tracheostomy and to prevent ventilatory dyssynchrony. Objective: describing the pharmacotherapeutic profile and epidemiological characteristics of severe COVID-19 patients who required IMV and were admitted to the Intensive Care Unit (ICU) covid. Methodology: This is a descriptive, retrospective study with analysis of medical records of patients confirmed with Covid-19, and submitted to IMV with associated use of pharmacotherapy and hospitalized in ICUs-Covid from January to December 2021, in a private sector hospital in Western Paraná. Results: The medical records of 81 patients with severe acute respiratory syndrome (SARS) who underwent IMV and who used medications, analgesics, NMB, antipsychotics and antidepressants to induce, maintain, or remove IMV were analyzed. It was observed in the medical records that 100% of patients in critical condition required orotracheal intubation (OTI), and that 24.7% evolved to tracheostomy (TCT). In the description of the medical records, the average length of stay in the intensive care unit and mechanical ventilation were 31.71 and 22.95 days, respectively. Regarding the pharmacotherapy used during the course of treatment, the most prescribed drugs were fentanyl with 93.8% of prescriptions, midazolam 91.4%, rocuronium 88.9%, dexmedetomidine 64.2% and morphine with 55.6% %. The mean age of the 81 patients was 59 years, 43 (53%) were male, 30 (37%) had completed school education. Regarding the clinical evolution of the patients, 34 (42%) patients were discharged and 47 (58%) patients died. The average age of patients who died was 63 years. Conclusion: The data collected in this study supported a therapeutic protocol established for the care of patients diagnosed with Covid-19 and hospitalized in the ICU, especially with regard to drug therapy, patients who needed mechanical ventilation made use of fentanyl and midazolam and the neuromuscular blocker rocuronium, all established protocols had recommended maintenance during the evaluated period, which provided a high survival rate for hospitalized patients and especially for those who underwent the tracheostomy procedure. |
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Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western ParanáPerfil farmacoterapêutico e epidemiológico de pacientes Covid-19 submetidos a ventilação mecânica invasiva em um hospital privado do oeste do ParanáCovid-19Ventilação MecânicaSedativosAnalgésicosBloqueador Neuro muscularCovid-aInvasive mechanical ventilationSedative and AnalgesicNeuromuscular BlockerIntroduction: Pharmacotherapeutic treatment in the context of Covid-19 presented complex challenges for multidisciplinary teams. Medicines played a very important role in the recovery of the health of patients with covid-19 disease, among the most prescribed classes are sedatives, benzodiazepines, analgesics, neuromuscular blockers, antipsychotics and antidepressants, administered for induction , maintenance and/or withdrawal of invasive mechanical ventilation (IMV). These procedures, in addition to fulfilling the anxiolytic, hypnotic and amnestic needs of these patients, aimed to alleviate the discomfort associated with orotracheal intubation and tracheostomy and to prevent ventilatory dyssynchrony. Objective: describing the pharmacotherapeutic profile and epidemiological characteristics of severe COVID-19 patients who required IMV and were admitted to the Intensive Care Unit (ICU) covid. Methodology: This is a descriptive, retrospective study with analysis of medical records of patients confirmed with Covid-19, and submitted to IMV with associated use of pharmacotherapy and hospitalized in ICUs-Covid from January to December 2021, in a private sector hospital in Western Paraná. Results: The medical records of 81 patients with severe acute respiratory syndrome (SARS) who underwent IMV and who used medications, analgesics, NMB, antipsychotics and antidepressants to induce, maintain, or remove IMV were analyzed. It was observed in the medical records that 100% of patients in critical condition required orotracheal intubation (OTI), and that 24.7% evolved to tracheostomy (TCT). In the description of the medical records, the average length of stay in the intensive care unit and mechanical ventilation were 31.71 and 22.95 days, respectively. Regarding the pharmacotherapy used during the course of treatment, the most prescribed drugs were fentanyl with 93.8% of prescriptions, midazolam 91.4%, rocuronium 88.9%, dexmedetomidine 64.2% and morphine with 55.6% %. The mean age of the 81 patients was 59 years, 43 (53%) were male, 30 (37%) had completed school education. Regarding the clinical evolution of the patients, 34 (42%) patients were discharged and 47 (58%) patients died. The average age of patients who died was 63 years. Conclusion: The data collected in this study supported a therapeutic protocol established for the care of patients diagnosed with Covid-19 and hospitalized in the ICU, especially with regard to drug therapy, patients who needed mechanical ventilation made use of fentanyl and midazolam and the neuromuscular blocker rocuronium, all established protocols had recommended maintenance during the evaluated period, which provided a high survival rate for hospitalized patients and especially for those who underwent the tracheostomy procedure.Introdução: O tratamento farmacoterapêutico no cenário da Covid-19 apresentou desafios complexos para as equipes multidisciplinares. Os fármacos ocuparam um espaço muito importante na recuperação da saúde de pacientes com a doença da covid-19, entre as classes mais prescritas encontram-se os sedativos, os benzodiazepínicos, os analgésicos, os bloqueadores neuromusculares, os antipsicóticos e os antidepressivos, administrados para indução, manutenção e/ou desmame da ventilação mecânica invasiva (VMI). Esses procedimentos, além de atenderem às necessidades ansiolíticas, hipnóticas e amnésicas desses pacientes, visaram aliviar o desconforto associado à intubação orotraqueal e a traqueostomia e prevenir a dessincronia ventilatória. Objetivo: deste estudo foi descrever o perfil farmacoterapêutico e as características epidemiológicas dos pacientes graves com COVID-19 que necessitaram de VMI e foram internados em Unidade de Terapia Intensiva (UTI) covid. Metodologia: Trata-se de um estudo descritivo, retrospectivo com análise de prontuários de pacientes confirmados com Covid-19, e submetidos a VMI com uso da farmacoterapia associada e hospitalizados em UTIs- Covid no período de janeiro a dezembro de 2021, em um hospital privado do oeste do Paraná. Resultados: Foram analisados prontuários de 81 pacientes com síndrome respiratória aguda grave (SRGA) submetidos a VMI e que fizeram uso de medicamentos, analgésicos, BNM, antipsicóticos e antidepressivos para induzir, manter, ou realizar o desmame da VMI. Observou-se nos prontuários avaliados que 100% dos pacientes em estado crítico necessitaram de intubação orotraqueal (IOT), e que 24,7% evoluíram para traqueostomia (TQT). Na descrição dos prontuários os tempos médios de permanência na unidade de terapia intensiva e de ventilação mecânica foram de 31,71 e 22,95 dias, respectivamente. Em relação a farmacoterapia utilizada durante a evolução do tratamento, os medicamentos mais prescritos foram o fentanil com 93,8% das prescrições, midazolam 91,4%, rocurônio 88,9%, dexmedetomidina 64,2% e a morfina com 55,6%. A média de idade dos 81 pacientes foi de 59 anos, sendo 43 (53%) eram do sexo masculino, 30 (37%) possuíam educação básica. Em relação à evolução clínica dos pacientes, 34 (42%) pacientes tiveram alta e 47 (58%) pacientes foram a óbito. A idade média dos pacientes que faleceram foi de 63 anos. Conclusão: Conclui-se que os dados coletados neste estudo fundamentaram um protocolo terapêutico estabelecido para atendimento de pacientes diagnosticados com a Covid-19 e hospitalizado em UTI, principalmente no que se refere a terapia medicamentosa os pacientes que necessitaram de ventilação mecânica fizeram o uso dos medicamentos fentanil e o midazolam e o bloqueador neuromuscular rocurônio, todos os protocolos estabelecidos tiveram manutenção recomendada durante o período avaliado o que proporcionou uma alta taxa de sobrevida dos pacientes hospitalizados e principalmente os que foram submetidos ao procedimento de traqueostomia.Editora JRG2023-06-27info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionArtigo avaliado pelos Paresapplication/pdfhttp://revistajrg.com/index.php/jrg/article/view/65810.5281/zenodo.8091777ark:/57118/JRG.v6i13.658JRG Journal of Academic Studies; Vol. 6 No. 13 (2023): JRG Journal of Academic Studies; 1158-1175JRG Journal of Academic Studies ; Vol. 6 Núm. 13 (2023): Revista JRG de Estudos Acadêmicos; 1158-1175JRG Journal of Academic Studies; V. 6 N. 13 (2023): Revista JRG de Estudos Acadêmicos; 1158-1175Revista JRG de Estudos Acadêmicos ; v. 6 n. 13 (2023): Revista JRG de Estudos Acadêmicos; 1158-11752595-1661ark:/57118/jrg.v6i13reponame:Revista JRG de Estudos Acadêmicosinstname:Editora JRGinstacron:JRGporhttp://revistajrg.com/index.php/jrg/article/view/658/654https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessAntunes, Carina FabríciaGoncalves, Monique Sabec-Pereira, Dayane Kelly da Luz , Marcos Antonio2023-08-08T19:46:26Zoai:ojs2.revistajrg.com:article/658Revistahttp://revistajrg.com/index.php/jrgPRIhttp://revistajrg.com/index.php/jrg/oaiprofessorjonas@gmail.com||2595-16612595-1661opendoar:2023-08-08T19:46:26Revista JRG de Estudos Acadêmicos - Editora JRGfalse |
dc.title.none.fl_str_mv |
Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná Perfil farmacoterapêutico e epidemiológico de pacientes Covid-19 submetidos a ventilação mecânica invasiva em um hospital privado do oeste do Paraná |
title |
Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná |
spellingShingle |
Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná Antunes, Carina Fabrícia Covid-19 Ventilação Mecânica Sedativos Analgésicos Bloqueador Neuro muscular Covid-a Invasive mechanical ventilation Sedative and Analgesic Neuromuscular Blocker |
title_short |
Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná |
title_full |
Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná |
title_fullStr |
Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná |
title_full_unstemmed |
Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná |
title_sort |
Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná |
author |
Antunes, Carina Fabrícia |
author_facet |
Antunes, Carina Fabrícia Goncalves, Monique Sabec-Pereira, Dayane Kelly da Luz , Marcos Antonio |
author_role |
author |
author2 |
Goncalves, Monique Sabec-Pereira, Dayane Kelly da Luz , Marcos Antonio |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Antunes, Carina Fabrícia Goncalves, Monique Sabec-Pereira, Dayane Kelly da Luz , Marcos Antonio |
dc.subject.por.fl_str_mv |
Covid-19 Ventilação Mecânica Sedativos Analgésicos Bloqueador Neuro muscular Covid-a Invasive mechanical ventilation Sedative and Analgesic Neuromuscular Blocker |
topic |
Covid-19 Ventilação Mecânica Sedativos Analgésicos Bloqueador Neuro muscular Covid-a Invasive mechanical ventilation Sedative and Analgesic Neuromuscular Blocker |
description |
Introduction: Pharmacotherapeutic treatment in the context of Covid-19 presented complex challenges for multidisciplinary teams. Medicines played a very important role in the recovery of the health of patients with covid-19 disease, among the most prescribed classes are sedatives, benzodiazepines, analgesics, neuromuscular blockers, antipsychotics and antidepressants, administered for induction , maintenance and/or withdrawal of invasive mechanical ventilation (IMV). These procedures, in addition to fulfilling the anxiolytic, hypnotic and amnestic needs of these patients, aimed to alleviate the discomfort associated with orotracheal intubation and tracheostomy and to prevent ventilatory dyssynchrony. Objective: describing the pharmacotherapeutic profile and epidemiological characteristics of severe COVID-19 patients who required IMV and were admitted to the Intensive Care Unit (ICU) covid. Methodology: This is a descriptive, retrospective study with analysis of medical records of patients confirmed with Covid-19, and submitted to IMV with associated use of pharmacotherapy and hospitalized in ICUs-Covid from January to December 2021, in a private sector hospital in Western Paraná. Results: The medical records of 81 patients with severe acute respiratory syndrome (SARS) who underwent IMV and who used medications, analgesics, NMB, antipsychotics and antidepressants to induce, maintain, or remove IMV were analyzed. It was observed in the medical records that 100% of patients in critical condition required orotracheal intubation (OTI), and that 24.7% evolved to tracheostomy (TCT). In the description of the medical records, the average length of stay in the intensive care unit and mechanical ventilation were 31.71 and 22.95 days, respectively. Regarding the pharmacotherapy used during the course of treatment, the most prescribed drugs were fentanyl with 93.8% of prescriptions, midazolam 91.4%, rocuronium 88.9%, dexmedetomidine 64.2% and morphine with 55.6% %. The mean age of the 81 patients was 59 years, 43 (53%) were male, 30 (37%) had completed school education. Regarding the clinical evolution of the patients, 34 (42%) patients were discharged and 47 (58%) patients died. The average age of patients who died was 63 years. Conclusion: The data collected in this study supported a therapeutic protocol established for the care of patients diagnosed with Covid-19 and hospitalized in the ICU, especially with regard to drug therapy, patients who needed mechanical ventilation made use of fentanyl and midazolam and the neuromuscular blocker rocuronium, all established protocols had recommended maintenance during the evaluated period, which provided a high survival rate for hospitalized patients and especially for those who underwent the tracheostomy procedure. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-06-27 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Artigo avaliado pelos Pares |
format |
article |
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publishedVersion |
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http://revistajrg.com/index.php/jrg/article/view/658 10.5281/zenodo.8091777 ark:/57118/JRG.v6i13.658 |
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http://revistajrg.com/index.php/jrg/article/view/658 |
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10.5281/zenodo.8091777 ark:/57118/JRG.v6i13.658 |
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por |
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por |
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http://revistajrg.com/index.php/jrg/article/view/658/654 |
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https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
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JRG Journal of Academic Studies; Vol. 6 No. 13 (2023): JRG Journal of Academic Studies; 1158-1175 JRG Journal of Academic Studies ; Vol. 6 Núm. 13 (2023): Revista JRG de Estudos Acadêmicos; 1158-1175 JRG Journal of Academic Studies; V. 6 N. 13 (2023): Revista JRG de Estudos Acadêmicos; 1158-1175 Revista JRG de Estudos Acadêmicos ; v. 6 n. 13 (2023): Revista JRG de Estudos Acadêmicos; 1158-1175 2595-1661 ark:/57118/jrg.v6i13 reponame:Revista JRG de Estudos Acadêmicos instname:Editora JRG instacron:JRG |
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