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In your last edition, a North American weekly magazine ScienceConsidered to be the most important medical publication in the world, I should highlight one article that deals with the evolution of the treatment with covid-19 with heparin — an anticoagulant indicated for reversal of thrombose. Studies conducted by doctors from different countries of the world have verified the effectiveness of the drug in reducing two stages of intuition and hospitalization in severe cases.
Specialists interviewed did not report that they would be taking the medicine thanks to a strange phenomenon perceived by patients. Even if he is presenting a low oxygen tax, he does not bleed, he will not be feeling any discomfort to breathe.
Subtle coagulation
In the absence of correspondence between the account of what was being verified by the monitors, secondly, explained now to the doctors, because they continue to function regularly, it is not the beginning of the infection with a subtle coagulation of the finest vessels in the blood network that is It finds the extremity of two alveoli —or that prevented proper oxygenation.
In the normal conditions, the oxygen saturation tax does not bleed and 95%. In serious cases of doença caused by novo coronavirus, this tax can be at 70%, 60% or at least 50%, it is measured as an equipment that is attached to a finger —or, eventually, confirmed in blood tests.
Protein leak
The first time to observe isso no Brazil was from São Paulo pneumologist Elnara Marcia Negri, from the Hospital Sirio Libanês and da USP (Universidade de São Paulo). TO ScienceElnara explained that in severe cases of covid-19 or a greater problem it is not properly said, but the coagulation of its fine blood network. “To evasion in the protein cascade of blood clotting, or to impede adequate oxygenation,” he says.
Elnara says that she perceives when she attends her first patient with covid-19. She was a gossip who, together with difficulty in breathing, went on to present circulatory problems with a finger: “Ficou roxo, at the same time that houve been abrupt in oxygenation,” gave birth to a doctor.
Because of thrombosis, the Elnara team medicated a patient with heparin, which is a basic blood refiner. In a short time, the oxygenation had returned to normal, the patient breathed less or the finger was not more red. A medical passou to consider or anticoagulant as an important resource to promote or respiratory impulse of patients with low oxygen level, including those who do not have difficulty in breathing.
Quase 90% recovery
On April 20, Elnara posed a preliminary study detailing the non-Syrian Libanês experience in 27 patients with covid-19. He reported that the people with low oxygen did not bleed, received heparin, and that it was strengthened as many high levels of D-dimer were detected, a marker of blood that measured excessive coagulation.
Among the 27 of you, you have not been accompanied because you have been transferred to another hospital; You are maintained in a serious condition, and 24 will recover from infection, including four who have been subjected to mechanical ventilation. It deals with the highest recovery tax seen from the start of the pandemic, second to Science.
Elnara warns that heparin is a medication for hospital use. Taking a drug by yourself can lead to death.
World chancela
According to Elbio Antônio D’Amico, hematologist at the Hospital das Clínicas, or the increase in blood clotting, it becomes more intense according to the life of the doctor. “This increase is quantified, and the results are compatible with what is called a disseminated intravascular coagulation and induced coagulopathy for sepsis or viral hair,” he said.
D’Amico quotes a Chinese job published in March no Jornal of Thrombosis and Haemostasis, which showed that heparin reduced by 24% to fatality, not the twenty-eighth day of its accompaniment. “From then on, several entities, such as the Spanish Sociedade de Trombose e Hemostasia, the Italian Sociedade de Estudos de Hemostasia e Trombose, the Chinese companies and the public health service indicated for or prophylactic use of heparin in all severe patients with covid- 19, with increasing dose according to the weight of the patient, and observing other cramps for clot thrombosis and hemorrhagic complications. “
Knowing that nós, ocidentais, fear or increased cliff for thrombose, as heparin doses administered superior foram e, according to medical or medical, obtained quite satisfactory results. A dúvida that appears, according to D’Amico, he is now a patient of the anti-coagulant of the heparin or the anti-inflammatory.
Muitas considerate
Interviewed for o artigo, or emergencist Reuben Strayer, of the Mainmonides Medical Center, in New York, it is reasonable to conclude that due to blood clotting in a tiny network of vessels two lungs. He says that his own is administering heparin in his patients, but he confirms that “it is simply not known” is due to coagulation and is solely responsible for respiratory problems. “There are many things to consider,” says ele à Science.
Nicholas Caputo, from New York City Health + Hospitals / Lincoln, says that he has not yet experienced and discovered. Caputo says that a patient with low oxygen does not bleed chegou to present an unexpected wax wax membrane in two dozen lungs. “Eu não sei o de fato happens pathophysiologically nessa doença”, disse à revista.
The war
Year UOLElnara said that she is ministering anticoagulant to all the seriously ill patients she cares for. Até or momento, foram 60. “Sete ainda estão na UTI (Unit of Intensive Care), or remaining foi for a nurse or high discharge.” She basically defeats two Syrian Libanês hospitals on July 9. “We are disseminating to the maximum our experience and observation in a public network.”
Second ela, or protocol ainda não é applied in all you hospital, “because nem all the colleagues accredit me no treatment”. “They want to be based on evidence based on randomized studies. It happens that we are not at the end of the war, and for that reason, as we can see, a clinical observation associated with autopsy data must be lifted in consideration.”
I attached that an efficient treatment was provided, she explains, tests must be carried out with 300 people – two groups of 150 each. “Metade receives heparin, metade, no. We will have these results shortly,” he said.
* Paulo Sampaioé Colunista do UOL and specialist in social coverage, with a publication of behavioral materials and interviews with artists, politicians, celebrities, doctors, athletes and madames.
