Complicações e terapias de suporte utilizadas em crianças e adolescentes internadas com covid-19: uma revisão integrativa
Complications and supportive therapies used in children and adolescent hospitalized with covid-19: a integrative review
DOI:
https://doi.org/10.33362/ries.v15i1.3382Palavras-chave:
COVID-19, Unidades de terapia intensiva pediátrica, Criança, AdolescenteResumo
A COVID-19, causada pelo SARS-CoV-2, embora apresente curso predominantemente leve em crianças e adolescentes, pode evoluir para formas graves que exigem internação em Unidade de Terapia Intensiva Pediátrica (UTIP), com ocorrência de complicações respiratórias e sistêmicas e necessidade de terapias de suporte avançadas. Diante da relevância clínica desse cenário, este estudo teve como objetivo identificar, na literatura científica, as principais complicações e as terapias de suporte utilizadas em crianças e adolescentes com COVID-19 internados em UTIP. Trata-se de uma revisão integrativa da literatura, realizada em 8 de março de 2022, nas bases Biblioteca Virtual em Saúde (BVS), PubMed/MEDLINE e SciELO, com descritores controlados e operadores booleanos. Foram incluídos artigos originais publicados entre 2020 e 2022, nos idiomas português, inglês e espanhol, que abordassem pacientes pediátricos internados em UTI, excluindo-se estudos com população adulta, terapias exclusivamente medicamentosas ou nutricionais, trabalhos acadêmicos e duplicidades. A busca identificou 903 estudos, dos quais 19 compuseram a amostra final após aplicação dos critérios de elegibilidade e leitura na íntegra. As complicações foram síndrome do desconforto respiratório agudo, pneumonia, disfunção cardíaca e lesão renal aguda, sendo as terapias mais utilizadas ventilação mecânica invasiva e não invasiva, oxigenoterapia, cânula nasal de alto fluxo, ECMO e posição prona. Conclui-se que casos pediátricos graves demandam suporte intensivo e manejo multiprofissional especializado.
Palavras-chave: COVID-19. Unidades de terapia intensiva pediátrica. Criança. Adolescente.
Abstract: COVID-19, caused by SARS-CoV-2, although predominantly mild in children and adolescents, can progress to severe forms requiring admission to a Pediatric Intensive Care Unit (PICU), with respiratory and systemic complications and the need for advanced supportive therapies. Given the clinical relevance of this scenario, this study aimed to identify, in the scientific literature, the main complications and supportive therapies used in children and adolescents with COVID-19 admitted to PICUs. This is an integrative literature review, conducted on March 8, 2022, in the Virtual Health Library (VHL), PubMed/MEDLINE, and SciELO databases, with controlled descriptors and Boolean operators. Original articles published between 2020 and 2022, in Portuguese, English, and Spanish, addressing pediatric patients admitted to PICUs were included, excluding studies with adult populations, exclusively pharmacological or nutritional therapies, academic works, and duplicates. The search identified 903 studies, of which 19 comprised the final sample after applying the eligibility criteria and reading the full text. The complications were acute respiratory distress syndrome, pneumonia, cardiac dysfunction, and acute kidney injury, with the most frequently used therapies being invasive and non-invasive mechanical ventilation, oxygen therapy, high-flow nasal cannula, ECMO, and prone positioning. It is concluded that severe pediatric cases require intensive support and specialized multidisciplinary management.
Keywords: COVID-19. Intensive Care Units, Pediatric. Child. Adolescent.
Resumen: La COVID-19, causada por el SARS-CoV-2, aunque predominantemente leve en niños y adolescentes, puede progresar a formas graves que requieren ingreso en una Unidad de Cuidados Intensivos Pediátricos (UCIP), con complicaciones respiratorias y sistémicas y la necesidad de terapias de soporte avanzadas. Dada la relevancia clínica de este escenario, este estudio tuvo como objetivo identificar, en la literatura científica, las principales complicaciones y terapias de soporte utilizadas en niños y adolescentes con COVID-19 ingresados en UCIP. Se trata de una revisión integrativa de la literatura, realizada el 8 de marzo de 2022 en las bases de datos de la Biblioteca Virtual en Salud (BVS), PubMed/MEDLINE y SciELO, con descriptores controlados y operadores booleanos. Se incluyeron artículos originales publicados entre 2020 y 2022, en portugués, inglés y español, dirigidos a pacientes pediátricos ingresados en UCIP, excluyendo estudios con poblaciones adultas, terapias exclusivamente farmacológicas o nutricionales, trabajos académicos y duplicados. La búsqueda identificó 903 estudios, de los cuales 19 constituyeron la muestra final tras aplicar los criterios de elegibilidad y leer el texto completo. Las complicaciones fueron síndrome de dificultad respiratoria aguda, neumonía, disfunción cardíaca y lesión renal aguda, siendo las terapias más utilizadas la ventilación mecánica invasiva y no invasiva, la oxigenoterapia, la cánula nasal de alto flujo, la ECMO y el decúbito prono. Se concluye que los casos pediátricos graves requieren apoyo intensivo y un manejo multidisciplinario especializado.
Palabras clave: COVID-19. Unidades de cuidado intensivo pediátrico. Niño. Adolescente.
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