HU - Hospital Universitário

URI Permanente desta comunidadehttps://repositorio.univasf.edu.br/handle/123456789/1307

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    Associação entre padrões pressóricos de 24 h e remodelamento cardíaco ao ecocardiograma em pacientes com insuficiência cardíaca de ejeção reduzida: subanálise do estudo IMPACT-HF
    (2026-05-27) Diniz Junior, Edvaldo Alves; Armstrong, Anderson da Costa
    This research is a cross-sectional, descriptive, and exploratory analytical study of patients with heart failure with reduced ejection fraction (LVEF < 40%) included in the IMPACT-HF study, who underwent ambulatory blood pressure monitoring (ABPM) and echocardiography before the start of the intervention. The recruitment period was from September 2024 to February 2026, totaling a sample size of 21 patients with a mean age of 52.4 ± 9.0 years, predominantly male (66.7%; 95% CI: 46.4% – 86.9%). Its objective is to correlate ABPM blood pressure patterns with echocardiographic phenotypes in this group of patients, in order to evaluate the association between ABPM patterns and echocardiographic markers of remodeling. To assess the associations between the qualitative variables of ABPM and the echocardiographic domains, the Chi-square test of independence or, preferably, Fisher's exact test was applied, with the level of statistical significance set at 5% (p < 0.05) for all tests performed. The data obtained revealed a negative correlation between the percentage of nocturnal decrease in systolic blood pressure and the E/A ratio (r = -0.527; p = 0.017), highlighting that the "Non-Dipper" and "Riser" patterns are associated with worsening diastolic dysfunction indices and increased filling pressures of the cardiac chambers. The "Non- Dipper" pattern was also associated with ventricular remodeling, accounting for 40% of all cases of hypertrophy and chamber dilation. Altered systolic pressure load (≥ 20%) showed a strong positive association with relative left ventricular wall thickness (r = 0.557; p = 0.009) and an inverse association with indexed end-diastolic volume (r = -0.502; p = 0.020), relating increased pressure load to myocardial thickening and consequent restriction of the ventricular cavity's dilation and accommodation capacity. Finally, this study did not correlate a more stringent blood pressure target (SBP < 120 mmHg) with echocardiographic worsening in this patient profile.
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    Perfil clínico-epidemiológico e microbiológico das pneumonias associadas à ventilação mecânica na unidade de terapia intensiva de hospital universitário do sertão do Pernambuco
    (2026-05-21) Pinto, João Pedro de Carvalho; Naue, Carine Rosa; Aquino, Samuel Ricarte de
    Background: Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in intensive care units, associated with increased morbidity and mortality, prolonged hospital stay, and higher healthcare costs. Understanding the clinical, epidemiological, and microbiological profile of affected patients is essential to guide prevention and treatment strategies.Objective: To describe the clinical, epidemiological, and microbiological profile of patients diagnosed with VAP in the intensive care unit of a university hospital in the São Francisco Valley. Methods: This is a cross-sectional, analytical, and retrospective study including 107 patients diagnosed with VAP between January 2023 and July 2025 at the University Hospital of the Federal University of Vale do São Francisco (HU-UNIVASF). Sociodemographic, clinical, microbiological, and outcome data were collected from electronic medical records. Continuous variables were expressed as mean and standard deviation, while categorical variables were presented as absolute and relative frequencies. Statistical analysis was performed using Student’s t-test and the chi-square test. Results: A predominance of male patients (75.7%) was observed, with a mean age of 47.8 ± 19.6 years. The main causes of admission were trauma-related conditions, particularly traumatic brain injury (53.7%) and polytrauma from traffic accidents (28.0%). Microbiological analysis showed a predominance of Gram-negative bacteria (76.4%), with Acinetobacter baumannii being the most frequent pathogen (40.2%), followed by Staphylococcus aureus (21.5%), Pseudomonas aeruginosa (17.8%), and Klebsiella pneumoniae (13.1%). The mean hospital length of stay was 49.1 days, and the mean duration of mechanical ventilation was 21.3 days. The mortality rate was 28%, with higher mean age among non-survivors compared to survivors (56.9 ± 21.3 vs. 43.5 ± 18.4 years; p = 0.012). Conclusion: VAP predominantly affected male patients with trauma-related conditions, especially traumatic brain injury and polytrauma, and was associated with a predominance of Gram-negative pathogens, high mortality, and prolonged hospitalization and mechanical ventilation. Higher CPIS scores were not associated with worse outcomes.