ABSTRACT
RESUMEN Objetivo: El coronavirus ha emergido este año como causa de neumonía viral. Una de las principales características es su rápida transmisión y su potencial severidad. El objetivo de este estudio de serie de casos es describir las características clínicas de los pacientes con confirmación de enfermedad por coronavirus (COVID-19) admitidos en diferentes unidades de cuidados intensivos de la Argentina con requerimiento de ventilación mecánica. Métodos: Estudio de serie de casos, descriptivo-prospectivo, multicéntrico realizado entre el 01 de abril y el 08 de mayo de 2020. Se incluyeron los datos de los pacientes mayores a 18 años, que ingresaron a la unidad de cuidados intensivos con requerimiento de ventilación mecánica por falla respiratoria aguda con diagnóstico positivo de COVID-19 Resultados: Se registraron las variables de 47 pacientes de 31 unidades cuidados intensivos, 78.7% hombres de una mediana de edad de 61 años, con un SAPS II de 43, un índice de Charlson de 3. El modo ventilatorio inicial fue volume control - continuous mandatory ventilation con volumen corriente menor a 8mL/kg en el 100% de los casos, con una mediana de presión positiva al final de la espiración de 10,5cmH2O. A la fecha de cierre del estudio, 29 pacientes fallecieron, 8 alcanzaron el alta, y 10 pacientes continúan internados al cierre del estudio. El SAPS II fue mayor entre los fallecidos (p = 0.046). El índice de Charlson se asoció con mayor mortalidad (OR = 2,27 IC95% 1,13 - 4,55; p = 0,02). Conclusión: Los pacientes con COVID-19 y ventilación mecánica de esta serie presentan variables clínicas similares a las descriptas a la fecha en otros reportes internacionales. Nuestros hallazgos proporcionan datos que permitirían de alguna manera predecir los resultados.
Abstract Objective: A novel coronavirus emerged this year as a cause of viral pneumonia. The main characteristics of the virus are rapid transmission, high contagion capacity and potential severity. The objective of this case series study is to describe the clinical characteristics of patients with confirmed coronavirus disease (COVID-19) admitted to different intensive care units in Argentina for mechanical ventilation. Methods: A descriptive, prospective, multicenter case series study was conducted between April 1 and May 8, 2020. Data from patients older than 18 years who were admitted to the intensive care unit for mechanical ventilation for acute respiratory failure with a positive diagnosis of COVID-19 were included. Results: The variables for 47 patients from 31 intensive care units were recorded: 78.7% were men (median age of 61 years), with a SAPS II score of 43 and a Charlson index score of 3. The initial ventilatory mode was volume control - continuous mandatory ventilation with a tidal volume less than 8mL/kg in 100% of cases, with a median positive end-expiratory pressure of 10.5cmH2O. At the end of the study, 29 patients died, 8 were discharged, and 10 remained hospitalized. The SAPS II score was higher among patients who died (p = 0.046). Charlson comorbidity index was associated with higher mortality (OR = 2.27, 95% CI 1.13 - 4.55, p = 0.02). Conclusion: Patients with COVID-19 and on mechanical ventilation in this series presented clinical variables similar to those described to date in other international reports. Our findings provide data that may predict outcomes.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pneumonia, Viral/therapy , Respiration, Artificial , Respiratory Insufficiency/therapy , Coronavirus Infections/therapy , Intensive Care Units , Argentina , Pneumonia, Viral/physiopathology , Respiratory Insufficiency/virology , Tidal Volume , Positive-Pressure Respiration , Coronavirus Infections/physiopathology , Pandemics , Betacoronavirus , SARS-CoV-2 , COVID-19ABSTRACT
Qualitative information was collected of 64 indigenous women in highland Guatemalan and 73 mestizo women throughout El Salvador via in-depth interviews and direct observations prior to the design of education/communication programs. Data were collected on beliefs, attitudes and values related to infant feeding in the first 24-36 months and on actual breastfeeding and weaning practices during health and illness. Findings on cultural factors were related to the infant feeding decisions of interviewed women and to patterns of breastfeeding initiation, exclusive breastfeeding, introduction of liquids and weaning foods into infants' diets. In both settings, despite important differences in cultural traditions, women hold very similar and strong beliefs, attitudes and values towards the qualities of breastmilk, breastfeeding, the nutritional needs of young children, and their own capacity of produce adequate quantities of milk of acceptable quality. These cultural factors color their interpretation of infant behaviors such as crying and influence their day-to-day decisions about infant feeding. Dominant in the resulting suboptimal feeding patterns is the almost complete absence of exclusive breastfeeding beyond the second month. These findings demostrate the persistence of cultural factors in infant feeding practices in the early months
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Breast Feeding , Health Knowledge, Attitudes, Practice , Infant Nutrition , Central America , El Salvador , GuatemalaABSTRACT
Qualitative information was collected of 64 indigenous women in highland Guatemalan and 73 mestizo women throughout El Salvador via in-depth interviews and direct observations prior to the design of education/communication programs. Data were collected on beliefs, attitudes and values related to infant feeding in the first 24-36 months and on actual breastfeeding and weaning practices during health and illness. Findings on cultural factors were related to the infant feeding decisions of interviewed women and to patterns of breastfeeding initiation, exclusive breastfeeding, introduction of liquids and weaning foods into infants' diets. In both settings, despite important differences in cultural traditions, women hold very similar and strong beliefs, attitudes and values towards the qualities of breastmilk, breastfeeding, the nutritional needs of young children, and their own capacity of produce adequate quantities of milk of acceptable quality. These cultural factors color their interpretation of infant behaviors such as crying and influence their day-to-day decisions about infant feeding. Dominant in the resulting suboptimal feeding patterns is the almost complete absence of exclusive breastfeeding beyond the second month. These findings demostrate the persistence of cultural factors in infant feeding practices in the early months