RESUMO
Una de las características de la afección pulmonar por enfermedad por coronavirus (COVID-19) es la disociación entre la gravedad de la hipoxemia y el mantenimiento de una mecánica respiratoria relativamente conservada. En este contexto se ha establecido una teoría en relación con dos fenotipos de pacientes con síndrome de distrés respiratorio del adulto (SDRA): un fenotipo Low, caracterizado por baja elastancia y baja reclutabilidad, y un fenotipo High, con características de alta elastancia y alta reclutabilidad. Presentamos el caso de un paciente que cursó internación en la Unidad de Terapia Intensiva de Adultos de nuestro hospital, con clínica, mecánica ventilatoria y patrón tomográfico compatible con el fenotipo Low de SDRA por COVID-19. (AU)
Dissociation between severity of hypoxemia and relative preserved respiratory mechanics is a characteristic observed in lung impairment due to coronavirus disease (COVID-19). Patients with COVID-19 that present adult respiratory distress syndrome (ARDS) are identified for one of two phenotypes according to a theory recently established. The Low phenotype is distinguished by low elastance and low recruitability; and the High phenotype, by high elastance and high recruitability. The case describes a patient admitted in the adult Intensive Care Unit of Hospital Italiano de Buenos Aires with observed symptoms, ventilatory mechanics and tomographic pattern that are compatible with Low phenotype of ARDS due to COVID-19. (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório do Recém-Nascido/microbiologia , Infecções por Coronavirus/terapia , Fenótipo , Síndrome do Desconforto Respiratório do Recém-Nascido/genética , Mecânica Respiratória , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Tosse/etiologia , Dispneia/etiologia , Febre/etiologia , Hipertensão/complicações , Unidades de Terapia Intensiva , Hipóxia/fisiopatologia , Obesidade/complicaçõesAssuntos
Mycoplasma pneumoniae , Pneumonia por Mycoplasma/congênito , Síndrome do Desconforto Respiratório do Recém-Nascido/complicações , Síndrome do Desconforto Respiratório do Recém-Nascido/microbiologia , Azitromicina/uso terapêutico , Betametasona/uso terapêutico , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Terapia Intensiva Neonatal , Masculino , Radiografia Torácica , Respiração ArtificialRESUMO
The incidence and outcome of Ureaplasma urealyticum infection were studied in 98 infants born before 34 weeks of gestational age. Infection was defined as the presence of one or more isolations of U. urealyticum in samples obtained from trachea, blood, cerebrospinal fluid, or postmortem brain or lung biopsies. Forty-seven infants were infected. Intact amniotic membranes had no protective effect against infection; intrauterine U. urealyticum infection was detected in 19 infants who were born by cesarean section with intact amniotic membranes. Respiratory distress syndrome, the need for assisted ventilation, severe respiratory insufficiency, and death were significantly more common among infected than among noninfected infants. Our results suggest that U. urealyticum infection is associated with an unfavorable short-term outcome in preterm infants.