Pharmacotherapeutic and epidemiological profile of Covid-19 patients undergoing invasive mechanical ventilation in a private hospital in Western Paraná
DOI:
https://doi.org/10.5281/zenodo.8091777Keywords:
Covid-a, Invasive mechanical ventilation, Sedative and Analgesic, Neuromuscular BlockerAbstract
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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