RESUMO: Objetivo: investigar a relação da procalcitonina no diagnóstico diferencial de coinfecção bacteriana em pacientes com Covid-19. Método: estudo transversal retrospectivo, realizado em unidade de terapia intensiva em hospital público do sul do Brasil, entre fevereiro e março de 2021, mediante formulário. Realizaram-se análises estatísticas descritivas e de associação entre variáveis. Resultados: dos 231 pacientes, 28,14% apresentaram infecção, 63,20% de sítio pulmonar, em 25% ocorreu isolamento de bactérias, 77,49% utilizaram antimicrobianos e em 14,72% dos casos foi observada procalcitonina > dois ng/mL. Houve associação significativa entre uso de antimicrobiano e infeção (p=0,001), isolamento de bactérias (p<0,001), topografia da infeção (p<0,001), valores de procalcitonina (p<0,001). O uso da procalcitonina mostrou associação com infeção bacteriana (p<0,001), isolamento de bactéria (p<0,001), uso de antimicrobianos (p=0,001), e óbito (p<0,001). Conclusão: a procalcitonina pode reduzir o uso empírico de antimicrobianos e estimular a detecção e identificação de patógenos, levando em consideração os dados clínicos e epidemiológicos. RESUMO Objetivo Covid19. Covid19 Covid 19. 19 Covid-19 Método retrospectivo Brasil 2021 formulário Realizaramse Realizaram se variáveis Resultados 23 2814 28 14 28,14 infecção 6320 63 20 63,20 pulmonar 25 7749 77 49 77,49 1472 72 14,72 ngmL ng mL ng/mL p=0,001, p0001 p p=0,001 , 0 001 (p=0,001) p<0,001, p<0,001 (p<0,001) p<0,001. . Conclusão patógenos epidemiológicos Covid1 1 Covid-1 202 2 281 28,1 632 6 63,2 774 7 4 77,4 147 14,7 p000 p=0,00 00 (p=0,001 p<0,00 (p<0,001 Covid- 28, 63, 77, 14, p00 p=0,0 (p=0,00 p<0,0 (p<0,00 p0 p=0, (p=0,0 p<0, (p<0,0 p=0 (p=0, p<0 (p<0, p= (p=0 p< (p<0 (p= (p< (p

ABSTRACT Objective: to investigate the relationship between procalcitonin in the differential diagnosis of bacterial coinfection in COVID-19 patients. Method: a cross-sectional retrospective study conducted between February and March 2021 in the Intensive Care Unit of a public hospital from southern Brazil by filling in a form. Descriptive statistical analyses were performed, as well as of association between variables. Results: of the 231 patients, 28.14% presented infection (63.20% in the lungs), 25% had bacteria isolated, 77.49% used antimicrobials and, in 14.72% of the cases, procalcitonin > 2 ng/mL. There was a significant association between antimicrobial use and infection (p=0.001), isolation of bacteria (p<0.001), topography of the infection (p<0.001) and procalcitonin values (p<0.001). Procalcitonin use showed an association with bacterial infection (p<0.001), isolation of bacteria (p<0.001), antimicrobial use (p=0.001) and death (p<0.001). Conclusion: procalcitonin can reduce empirical antimicrobial use and stimulate detection and identification of pathogens, taking into account the clinical and epidemiological data. Objective COVID19 COVID 19 COVID-1 patients Method crosssectional cross sectional 202 form performed variables Results 23 2814 28 14 28.14 63.20% 6320 63 20 (63.20 lungs, lungs , lungs) 25 isolated 7749 77 49 77.49 1472 72 14.72 cases ngmL ng mL ng/mL p=0.001, p0001 p p=0.001 0 001 p<0.001, p<0.001 (p<0.001 p<0.001. . (p=0.001 Conclusion pathogens data COVID1 1 COVID- 281 28.1 63.20 632 6 (63.2 774 7 4 77.4 147 14.7 p000 p=0.00 00 p<0.00 (p<0.00 (p=0.00 28. 63.2 (63. 77. 14. p00 p=0.0 p<0.0 (p<0.0 (p=0.0 63. (63 p0 p=0. p<0. (p<0. (p=0. (6 p=0 p<0 (p<0 (p=0 ( p= p< (p< (p= (p

RESUMEN Objetivo: investigar la relación de la procalcitonina en el diagnóstico diferencial de coinfección bacteriana en pacientes con COVID-19. Método: estudio transversal y retrospectivo realizado entre febrero y marzo de 2021 en la unidad de cuidados intensivos de un hospital público del sur de Brasil, por medio de un formulario. Se realizaron análisis estadísticos descriptivos y de asociación entre variables. Resultados: de los 231 pacientes, el 28,14% presentó infección (el 63,20% en los pulmones), en el 25% se aislaron las bacterias, el 77,49% utilizó antimicrobianos y en el 14,72% de los casos se empleó procalcitonina > 2 ng/mL. Hubo una significativa asociación entre uso de antimicrobianos e infección (p=0,001), aislamiento de bacterias (p<0,001), topografía de la infección (p<0,001) y valores de procalcitonina (p<0,001). La utilización de procalcitonina demostró estar asociada con infección bacteriana (p<0,001), aislamiento de bacterias (p<0,001), uso de antimicrobianos (p=0,001) y fallecimiento (p<0,001). Conclusión: la procalcitonina puede reducir el uso empírico de antimicrobianos y estimular la detección e identificación de patógenos, considerando los datos clínicos y empíricos. Objetivo COVID19. COVID19 COVID 19. 19 COVID-19 Método 202 Brasil formulario variables Resultados 23 2814 28 14 28,14 6320 63 20 63,20 pulmones, pulmones , pulmones) 25 7749 77 49 77,49 1472 72 14,72 ngmL ng mL ng/mL p=0,001, p0001 p p=0,001 0 001 p<0,001, p<0,001 (p<0,001 p<0,001. . (p=0,001 Conclusión patógenos empíricos COVID1 1 COVID-1 281 28,1 632 6 63,2 774 7 4 77,4 147 14,7 p000 p=0,00 00 p<0,00 (p<0,00 (p=0,00 COVID- 28, 63, 77, 14, p00 p=0,0 p<0,0 (p<0,0 (p=0,0 p0 p=0, p<0, (p<0, (p=0, p=0 p<0 (p<0 (p=0 p= p< (p< (p= (p

RESUMO Objetivo Descrever o efeito da conduta fonoaudiológica no processo de decanulação traqueal em indivíduos com traumatismo cranioencefálico (TCE). Método Estudo clínico transversal prospectivo controlado. Participaram deste estudo dois grupos de indivíduos com TCE confirmado por tomografia axial computadorizada, sendo o grupo de estudo (G1) e o grupo controle (G2) compostos por 30 indivíduos cada, com 25 (83,3%) indivíduos do gênero masculino e 5 (16,7%) do gênero feminino em cada grupo. A faixa etária variou de 18 a 53 anos, com média de 32 anos. Foi elaborado um instrumento de avaliação fonoaudiológica para indivíduos com TCE traqueostomizados composto por investigação do nível de consciência, cognição e deglutição (anexo 1) e conduta. O G1 recebeu a avaliação proposta pelo estudo e o G2, análise retrospectiva de prontuário sem avaliação fonoaudiológica. As variáveis, tempo de permanência com a traqueostomia e total de dias de internamento foram os marcadores de mensuração do efeito da conduta fonoaudiológica com esse instrumento nessa população. Resultados Verificou-se que o G1 obteve uma redução média de 4,2 dias de permanência com a traqueostomia e de 4,4 dias no tempo de internamento hospitalar quando comparado com G2, porém sem significância estatística (p = 0,2031). Conclusão O grupo que foi avaliado e recebeu a conduta fonoaudiológica proposta no instrumento obteve diminuição do tempo de permanência com a traqueostomia bem como redução do tempo de internamento hospitalar.

ABSTRACT Purpose To describe the effect of Speech-Language Pathology (SLP) management on the tracheal decannulation process in patients with traumatic brain injury (TBI). Methods Prospective controlled clinical study. Two groups of patients with TBI confirmed by computed axial tomography were included in the study group (G1) and control group (G2) composed of 30 individuals each, with 25 (83.3%) male and 5 (16.7%) female individuals in both groups. Patients’ age ranged from 18 to 53 years old – mean age was 32 years. A SPL assessment tool was developed for tracheostomized patients with TBI, composed of investigation of awareness level, cognition and swallowing (annex 1) and conduct. G1 underwent the assessment proposed by the study, and G2 was assessed by retrospective analysis of medical records without SLP evaluation. In this population, the variables time with tracheostomy and total days of hospitalization were the measurement markers for the effect of SLP conduct with this instrument. Results It was verified that G1 presented mean reduction of 4.2 days with tracheostomy and of 4.4 days in length of hospital stay when compared to G2. However, these figures are not statistically significant (p = 0.2031). Conclusion The group that was evaluated and received the SLP conduct proposed in the instrument presented a reduction in the time of permanence with tracheostomy, as well as in hospital stay.

Introduction The frequency of tracheostomy in patients with traumatic brain injury (TBI) contrasts with the lack of objective criteria for its management. The study arose from the need for a protocol in the decision to remove the tracheal tube. Objective To evaluate the applicability of a protocol for tracheal decannulation. Methods A prospective study with 20 patients, ranging between 21 and 85 years of age (average 33.55), 4 of whom were women (20%) and 16 were men (80%). All patients had been diagnosed by a neurologist as having TBI, and the anatomical region of the lesion was known. Patients were evaluated following criteria for tracheal decannulation through a clinical evaluation protocol developed by the authors. Results Decannulation was performed in 12 (60%) patients. Fourteen (70%) had a score greater than 8 on the Glasgow Coma Scale and only 2 (14%) of these were not able to undergo decannulation. Twelve (60%) patients maintained the breathing pattern with occlusion of the tube and were successfully decannulated. Of the 20 patients evaluated, 11 (55%) showed no signs suggestive of tracheal aspiration, and of these, 9 (82%) began training on occlusion of the cannula. The protocol was relevant to establish the beginning of the decannulation process. The clinical assessment should focus on the patient's condition to achieve early tracheal decannulation. Conclusion This study allowed, with the protocol, to establish six criteria for tracheal decannulation: level of consciousness, respiration, tracheal secretion, phonation, swallowing, and coughing.