28/Aug/2025
Elderly patients in crisis: unveiling outcomes and management approaches in severe COVID-19 cases – a retrospective analysis from Brazil
einstein (São Paulo). 28/Aug/2025;23:eAO1428.
View Article28/Aug/2025
Elderly patients in crisis: unveiling outcomes and management approaches in severe COVID-19 cases – a retrospective analysis from Brazil
DOI: 10.31744/einstein_journal/2025AO1428
Highlights ■ The elderly had higher severity, more comorbidities, and longer intensive care unit and hospital stays than adults. ■ They required more assistance resources and had higher hospital mortality. ■ Independent mortality predictors: age ≥60, frailty, arrhythmia, transplant, acute kidney injury, vasopressors and extracorporeal membrane oxygenation. ABSTRACT Objective: To analyze the sociodemographic and clinical characteristics, comorbidities, therapeutic resources, and mortality rates of elderly patients with COVID-19 admitted to an intensive care unit. Methods: This retrospective cohort study included patients […]
Keywords: Acute kidney injury; Aged; COVID-19; Critical care outcomes; Hospital mortality; Intensive care units; Length of stay; Mortality
13/Aug/2025
A prospective and longitudinal cohort study assessing postacute sequelae of SARS-CoV-2 infection in patients with cancer
einstein (São Paulo). 13/Aug/2025;23:eAO1139.
View Article13/Aug/2025
A prospective and longitudinal cohort study assessing postacute sequelae of SARS-CoV-2 infection in patients with cancer
DOI: 10.31744/einstein_journal/2025AO1139
Highlights High fatigue and nutritional risk at discharge improved over one year in cancer survivors. Psychological symptoms, such as anxiety, depression, and posttraumatic stress disorder, remained prevalent for one year. 66% of patients had lasting symptoms or impairments after 12 months of follow-up. Nutritional risk was resolved in the following year. ABSTRACT Objective: Post-COVID symptoms are frequent and can be debilitating, particularly in individuals with cancer. However, their impact on this population remains unclear. This study aimed to prospectively assess […]
Keywords: Activities of Daily Living; Anxiet; Coronavirus infections; COVID-19; Depression; Fatigue; Hospitalization; Intensive care units; Neoplasms; Patient discharge; Post-acute COVID-19 syndrome; SARS-CoV-2; Stress disorders, post-traumatic; Symptom assessment
02/Jul/2025
Cardiac tamponade in a newborn caused by a peripherally inserted central catheter: case report
DOI: 10.31744/einstein_journal/2025RC0634
ABSTRACT This article describes the occurrence of cardiac tamponade in a premature newborn after the use of a peripherally inserted central catheter at a university hospital in Brazil. Pericardiocentesis was performed, the catheter was repositioned using radiography, and minimal residual pericardial effusion was confirmed using echocardiography. The patient showed good progress and was discharged from the hospital on day 47 of life without any complications related to the event. Therefore, although adverse events may occur following the insertion of peripherally […]
Keywords: Cardiac tamponade; Catheters; Infant, Newborn; Infant, premature; Intensive care units; X-rays
25/Apr/2025
Impact of extubation failure on the duration of mechanical ventilation in the pediatric population
DOI: 10.31744/einstein_journal/2025AO0705
Highlights ■ In patients who experienced extubation failure, the total ventilation time was twice as long as that of patients with successful extubation. ■ The incidence of extubation failure was 5.2%, which is relatively low compared to other studies. ■ The study revealed no significant association between the presence of pre-existing illnesses and extubation outcomes. ■ Results indicated that the primary cause of extubation failure was upper airway obstruction, accounting for 67% of cases requiring reintubation. ABSTRACT Objective: To compare […]
Keywords: Airway extubation; Child; Intensive care units; Pediatric; Respiration artificial; Ventilator weaning
14/Mar/2025
Spiritual care in the intensive care unit. Is it already a reality?: an integrative review
DOI: 10.31744/einstein_journal/2025RW1081
ABSTRACT Introduction Spirituality has emerged as a phenomenon of interest in various global contexts. The adoption of spirituality as a fundamental aspect of healthcare remains underexplored, especially in critical environments such as intensive care units. Objective To identify strategies for incorporating spiritual care into adult intensive care environments through an integrative literature review. Methods An integrative review was conducted using the Embase, Web of Science, Medline/PubMed, PsycINFO, LILACS, and Cochrane Central databases. Twenty-one studies published in English, Spanish, or Portuguese […]
Keywords: Critical care; Health personnel; Intensive care units; Professional competence; Spiritual therapies; Spirituality
14/Mar/2025
Assessment of mortality due to severe SARS-CoV-2 infection in public and private intensive care units in Brazil: a multicenter retrospective cohort study
einstein (São Paulo). 14/Mar/2025;23(spe1):eAO1060.
View Article14/Mar/2025
Assessment of mortality due to severe SARS-CoV-2 infection in public and private intensive care units in Brazil: a multicenter retrospective cohort study
DOI: 10.31744/einstein_journal/2025AO1060
Highlights ■ Public intensive care unit COVID-19 patients presented with more comorbidities and higher severity at admission. ■ Public intensive care units required more invasive organ support (e.g., mechanical ventilation, vasopressors, and renal replacement therapy) but less non-invasive ventilation and high-flow nasal cannula than private intensive care units. ■ In-hospital mortality was higher in public intensive care units, with an increased risk of death even after adjusting for patient characteristics and illness severity at intensive care unit admission. ABSTRACT Objective: […]
Keywords: Coronavirus; Coronavirus infections; COVID-19; Critical care; Critical care outcomes; Intensive care units; Mortality; SARS-CoV-2
24/Jan/2025
Hand hygiene adherence in intensive care units: comparison before and during the COVID-19 pandemic in a municipality of São Paulo state
einstein (São Paulo). 24/Jan/2025;23:eAO0951.
View Article24/Jan/2025
Hand hygiene adherence in intensive care units: comparison before and during the COVID-19 pandemic in a municipality of São Paulo state
DOI: 10.31744/einstein_journal/2025AO0951
Highlights ■ The COVID-19 pandemic has increased adherence to hand hygiene in intensive care units. ■ Private hospitals recorded higher consumption of alcoholbased hand sanitizer. ■ Interventions are needed to help keep rates up. ABSTRACT Objective: Compare alcohol-based hand sanitizer use in intensive care units in a municipality in São Paulo state, before and during the coronavirus pandemic. Methods: Analytical retrospective study using indirect documentation, with data obtained from a notification spreadsheet for epidemiological indicators of healthcare-associated infection in the […]
Keywords: Coronavirus infections; COVID-19; Hand hygiene; Hand sanitizers; Intensive care units; Pandemics; Risk reduction behavior
21/Nov/2024
Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery
DOI: 10.31744/einstein_journal/2024RC1113
ABSTRACT Spontaneous non-aneurysmal aortic rupture is rare and is usually attributed to penetrating aortic ulcers, infections, tumor infiltrations, or inflammatory and collagen diseases. Chronic rupture is infrequent but extremely rare in non-aneurysmal aortas, which makes diagnosis difficult because the absence of an aneurysm can mislead the physician to rule out rupture. Here, we describe the case of an 85-year-old male, who was undergoing oncological investigation for weight loss, inappetence, and back pain. Computed tomography and magnetic resonance imaging performed 3 […]
Keywords: Aged, 80 and over; Aneurysm; Aneurysm, false; Angiography; Aorta, abdominal; Endovascular procedures; Intensive care units; Magnetic resonance imaging; Patient discharge; Penetrating atherosclerotic ulcer; Prostheses and implants; Rupture; spontaneous; Tomography, x-ray computed
21/Oct/2024
Uncomplicated circulatory shock: a narrative review
DOI: 10.31744/einstein_journal/2024RW0775
ABSTRACT Circulatory shock is a common fatal condition. Despite this, information on this syndrome in the current medical literature is fragmented and esoteric. Adherence to each basic element of care can have a profound impact on patient outcomes. Disturbances in pumping (cardiogenic), content/container relationship (hypovolemic and vasoplegic), or blockage in blood circulation (obstructive) can induce tissue hypoperfusion, causing hemodynamic shock. If not quickly reversed, hypoperfusion progresses to irreversible multi-organ failure. The course can be fatal even before reaching this stage […]
Keywords: Adrenal insufficiency; Anaphylaxis; Cardiac output; Cardiac tamponade; Fluid therapy; Hemodynamic monitoring; Hemodynamics; Intensive care units; Pulmonary embolism; Shock; Shock, cardiogenic; Shock, hemorrhagic; Shock, septic
07/Oct/2024
Comparing ensemble learning algorithms and severity of illness scoring systems in cardiac intensive care units: a retrospective study
einstein (São Paulo). 07/Oct/2024;22:eAO0467.
View Article07/Oct/2024
Comparing ensemble learning algorithms and severity of illness scoring systems in cardiac intensive care units: a retrospective study
DOI: 10.31744/einstein_journal/2024AO0467
Highlights Gradient Boosting Machine and Random Forest models were built for prediction of mortality at cardiac intensive care units. A total of 9,761 intensive care unit stays of patients admitted under a Cardiac Surgery and Cardiac Medical services were studied. The AUROC and AUPRC values were significantly superior to seven conventional systems compared. The machine learning models’ calibration curves were substantially closer to the ideal line. ABSTRACT Objective: Logistic Regression has been used traditionally for the development of most predictor […]
Keywords: Calibration; Cardiac surgery procedures; Ensemble learning; Intensive care units; Mortality; Risk Factors