Recomendações do uso da ventilação mecânica para crianças em suspeita ou confirmação de COVID-19*
Recommendations for the use of mechanical ventilation in children with suspected or confirmed COVID-19*
Simone Nascimento Santos Ribeiro, Lívia Barboza de Andrade, Mayson Láercio de Araújo Sousa, Guilherme Cherene Barros de Souza, Fernanda Cordoba Lanza
Resumo
Este documento tem por objetivo abordar os principais dados de suporte ventilatório, da ventilação mecânica em pacientes pediátricos com COVID-19. As manifestações clínicas da doença grave de COVID-19 em crianças ainda não foram completamente elucidadas, mas não se pode descartar que uma proporção de pacientes possa apresentar características clínicas muito parecidas com a bronquiolite, broncopneumonia, asma, pneumonite que são observadas em outras doenças respiratórias virais da infância. As informações dos casos que necessitam de cuidados intensivos e uso de ventilação mecânica são muito escassos e limitados, de maneira geral, os dados são compatíveis com uma infecção viral respiratória semelhante a outras. O consenso de especialistas Paediatric Mechanical Ventilation Consensus Conference (PEMVECC) e Pediatric Acute Lung Injury Consensus Conference (PALICC), apontam a adesão às recomendações sobre ventilação mecânica em crianças publicadas anteriormente e às recomendações práticas nas questões específicas relacionadas à doença de COVID-19 em crianças.
Palavras-chave
Abstract
This document aims to address the available data on ventilatory support and mechanical ventilation in pediatric patients with COVID-19. The clinical manifestations of severe COVID-19 disease in children have not yet been fully elucidated, but it cannot be ruled out that a proportion of patients may present with clinical characteristics very similar to bronchiolitis, bronchopneumonia, asthma or pneumonitis, conditions which are frequently observed in other childhood respiratory virus diseases. Information on cases requiring intensive care and about the use of mechanical ventilation is very scarce and limited. In general, these pieces of information seem to be similar to those used in other respiratory virus infections. The expert consensus documents from the Pediatric Mechanical Ventilation Consensus Conference (PEMVECC) and Pediatric Acute Lung Injury Consensus Conference (PALICC) recommend to follow previously published recommendations on mechanical ventilation in children and practical recommendations on specific issues related to COVID-19 in children.
Keywords
Referências
1. Brasil. Ministério da Saúde. Brasil registra 19.638 casos confirmados de coronavírus e 1.056 mortes [Internet]. Brasília: Ministério da Saúde; 2020 [cited 2020 Apr 11]. Available from: https://www.saude.gov.br/noticias/agencia-saude/46709-brasil-registra-19-638-casos-confirmados-de-coronavirus-e-1-057-mortes
2. Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19): situation summary [Internet]. Atlanta: Centers for Disease Control and Prevention; 2020. Available from: https://www.cdc.gov/ coronavirus/2019-ncov/summary.html
3. Kelvin AA, Halperin S. COVID-19 in children: the link in the transmission chain. Lancet Infect Dis. 2020 Jun;20(6):633-634. doi: 10.1016/S1473-3099(20)30236-X. Epub 2020 Mar 25.
4. Chen ZM, Fu JF, Shu Q. New coronavirus: new challenges for pediatricians. World J Pediatr. 2020 Jun;16(3):222. doi: 10.1007/s12519-020-00346-4. Epub 2020 Feb 10.
5. Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020 Jun;16(3):240-246. doi: 10.1007/s12519-020-00345-5. Epub 2020 Feb 5.
6. Qiu H, Wu J, Liang H, Yunling L, Song Q,, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020 Jun;20(6):689-696. doi: 10.1016/S1473-3099(20)30198-5. Epub 2020 Mar 25.
7. Kneyber MCJ, Medina A, Modesto i Alapont V, Blokpoe R, Brierley J, Chidini G, et al. Practice recommendations for managing children with proven or suspected COVID-19 [Internet]. Geneva: European Society for Paediatric and Neonatal Intensive Care; 2020. Available from: https://espnic-online.org/News/Latest-News/Practice-recommendations-for-managing-children-with-proven-orsuspected-COVID-19
8. ASSOBRAFIR. Aspectos epidemiológicos e atuação do fisioterapeuta na prevenção e tratamento da covid-19 na população infantil em ambiente hospitalar. Comunicação Oficial ASSOBRAFIR [Internet]. Brasília: Associação Brasileira de Fisioterapia Cardiorrespiratória e Fisioterapia em Terapia Intensiva; 2020. Available from: https://assobrafir.com.br/covid-19_pediatria/
9. Ferrés J. Comparison of two nebulized treatments in wheezing infants. Eur Respir J 1988; 1 (Suppl):306.
10. García-Sosa A, Orozco-Romero DP, Iglesias-Leboreiro J, Bernárdez-Zapata I, Rendón-Macías ME. Escala Wood Downes-Ferrés, una opción útil para identificar la gravedad en crisis asmática. Rev Mex Pediatr. 2018 Ene-Feb;85(1):11-16.
11. Majumder MS, Mandl KD. Early transmissibility assessment of a novel coronavirus in Wuhan, China. SSRN 2020; published online Jan 23 (version 1). SSRN. 2020 Jan 24 [cited 2020 Mar 20]:3524675. doi: 10.2139/ssrn.3524675. Preprint.
12. Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R et al. Diagnosis, treatment and prevention of 2019 novel coronavirus infection in children: expert’s consensus statement. World J Pediatr. 2020 Jun;16(3):223-231. doi: 10.1007/s12519-020-00343-7. Epub 2020 Feb 7.
13. Kneyber MCJ, de Luca D, Calderini E, Jarreau PH, Javouhey E, Lopez-Herce J, et al. Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical. Intensive Care Med. 2017 Dec;43(12):1764-1780. doi: 10.1007/s00134-017-4920-z. Epub 2017 Sep 22.
14. Kneyber MCJ, de Luca D, Calderini E, Jarreau P-H, Javouhey E, Lopez-Herce J, et al. Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC). Intensive Care Med. 2017 Dec;43(12):1764-1780. doi: 10.1007/s00134-017-4920-z. Epub 2017 Sep 22. Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015 Jun;16(5):428-39. doi: 10.1097/PCC.0000000000000350.
15. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China. Pediatrics. e20200702. doi: 10.1542/peds.2020-0702.
16. Kneyber MCJ, Medina A, Modesto i Alapont V, Blokpoe R, Brierley J, Chidini G, et al. Practice recommendations for the management of children with suspected or proven COVID-19 infections from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC) and the section Respiratory Failure from the European Society for Paediatric and Neonatal Intensive Care (ESPNIC) [Internet]. Geneva: European Society for Paediatric and Neonatal Intensive Care; 2020. Available from: https://espnic-online.org/content/download/3951/20876/file/2020 ESPNIC PEMVECC COVID-19 practice recommendations.pdf
17. Calvo C, García López-Hortelano M, de Carlos Vicente JC, Vázquez Martínez JL. Recomendaciones sobre el manejo clínico de la infección por el «nuevo coronavirus» SARS-CoV2. Grupo de trabajo de la Asociación Espanhola de Pediatría (AEP). An Pediatr (Barc) ; 92(4): 241.e1-241.e11, 2020 Apr.
18. Khemani RG, Parvathaneni K, Yehya N, Bhalla AK, Thomas NJ, Newth CJL. PEEP Lower Than the ARDS Net- work Protocol is Associated with Higher Pediatric ARDS Mortality. Am J Respir Crit Care
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email