RESUMO
PURPOSE: Since the SARS-CoV-2 pandemic, countries are overwhelmed by critically ill Coronavirus disease 2019 (COVID-19) patients. As ICU capacity becomes limited we characterized critically ill COVID-19 patients in the Netherlands. METHODS: In this case series, COVID-19 patients admitted to the ICU of the Jeroen Bosch Hospital were included from March 9 to April 7, 2020. COVID-19 was confirmed by a positive result by a RT-PCR of a specimen collected by nasopharyngeal swab. Clinical data were extracted from medical records. RESULTS: The mean age of the 50 consecutively included critically ill COVID-19 patients was 65 ± 10 years, the mean BMI was 29 ± 4.7 and 66% were men. Seventy-eight percent of patients had ≥1 comorbidity, 34% had hypertension. Ninety-six percent of patients required mechanical ventilation and 80% were ventilated in prone position. Venous thromboembolism was recognized in 36% of patients. Seventy-four percent of patients survived and were successfully discharged from the ICU, the remaining 26% died (median follow up 86 days). The length of invasive ventilation in survivors was 15 days (IQR 12-31). CONCLUSIONS: The survival rate of COVID-19 critically ill patients in our population is considerably better than previously reported. Thrombotic complications are commonly found and merit clinical attention. TRIAL REGISTRATION NUMBER: NL2020.07.04.01.
Assuntos
Tratamento Farmacológico da COVID-19 , Respiração Artificial , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Teste de Ácido Nucleico para COVID-19 , Cuidados Críticos , Estado Terminal/epidemiologia , Feminino , Hospitalização , Humanos , Unidades de Terapia Intensiva , Pulmão , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Pandemias , Alta do Paciente , Reação em Cadeia da Polimerase em Tempo RealRESUMO
Blunt vascular trauma in children is relatively rare and usually occurs in combination with fractures. Direct blunt trauma of the common femoral artery can lead to complete obstruction of the artery. In children, this obstruction may cause difference in limb growth. The authors describe a case of traumatic intimal rupture of the common femoral artery in an 11-year-old child after a fall from a bicycle. There have been a few reports of blunt trauma to the common femoral artery in children. The patient described had immediate symptoms of ischemia. Prompt reconstruction of the common femoral artery resulted in full recovery. Principles of arterial reconstruction in children are generally the same as in adults. The use of artificial grafts is to be avoided. Follow-up term is unclear as well as the use of anticoagulation therapy.