A oxigenação por membrana extracorpórea (ECMO) tem sido amplamente utilizada em pacientes com insuficiência respiratória grave causada pelo novo coronavírus (COVID-19). Nessas pessoas, o interstício pulmonar é ocupado por células e substâncias inflamatórias, o que prejudica as trocas gasosas e causa hipoxemia. O tratamento com ECMO consiste em impulsionar o sangue do enfermo através de uma cânula para uma membrana artificial capaz de oxigená-lo, que então está apto a retornar para o organismo. Objetivou-se identificar, em pacientes com insuficiência respiratória por COVID-19, se o tratamento ECMO comparado à terapêutica padrão proporciona melhoras no quadro clínico. Foi realizada, no mês de maio de 2021, uma revisão sistemática da literatura. A pesquisa foi realizada inicialmente em duas bases de dados: PubMed e BVS. Dos artigos resultantes, 7 foram selecionados por se encaixarem nos critérios de pesquisa. A partir da análise dos resultados, verificou-se que o tratamento com ECMO é capaz de reduzir a mortalidade dos pacientes que se encontram com insuficiência respiratória grave quando comparado aos outros tratamentos utilizados. Quando utilizado, esse recurso mostrou-se capaz de diminuir a quantidade de substâncias inflamatórias e a tempestade de citocinas, possibilitando, assim, a melhora no suprimento de oxigênio para os órgãos vitais e evitando lesões pulmonares decorrentes de danos mecânicos. Além disso, quando utilizada em conjunto com as medicações, mostrou redução da inflamação. Portanto, percebe-se que o ECMO é uma boa alternativa aos pacientes, porém não quando usado isoladamente. É necessário complementar o tratamento com medicações que aliviem os sintomas.
Objective: identify the impacts of increased exposure time to digital screens in childhood during the Covid-19 pandemic. Method: it was performed a field, cross-sectional and quantitative research. It was used a questionnaire in Google Forms released via email, Instagram and WhatsApp, with approval by the Research Ethics Committee of the institution. The final sample was composed by 246 parents and caregivers who answered the submitted questionnaire. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software using measures of relative (%) and absolute (N) frequency, descriptive tests of measures of central tendency (mean) and measures of dispersion (standard deviation). Inferential binary logistic regression tests (enter method) were performed to predict between the variables and Pearson's Chi-square of independence (2x2 and 2x4) for associations and prevalence calculations for each group. A statistical significance of p < 0.05 was adopted. Results: the interviewees reported that most of the children observed used the digital screens every day at week throughout the pandemic, with an average of 3 hours of daily use, starting at age three and the cell phone being the most frequent device used. A direct relationship was observed between longer exposure time and parental supervision in the use of digital technologies and greater daily use in children with 7 years of age or more. Final considerations: there was a significant increase in exposure time to digital screens in childhood during the Covid-19 pandemic, as most respondents reported that children used them daily, with a daily average of more than 3 hours. The impacts of this increased exposure time to digital screens in childhood during the Covid-19 pandemic involved impairments in brain functions, sleep, physical activity, social relationships and children's psychological well-being.
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