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    "titulo" => "Current practices of non-invasive respiratory therapies in COVID-19 patients in Portugal &#8212; A survey based in the abstracts of the 36th Congress of the Portuguese Society of Pulmonology"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Non-invasive respiratory therapies &#40;NIRT&#41; have become paramount interventions in the management of COVID-19 induced acute respiratory failure&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Recent data from the world&#8217;s largest database<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> suggests that 20&#37; of patients with COVID-19 were admitted at some point of their illness into an intensive care unit &#40;ICU&#41; or high dependency unit &#40;HDU&#41;&#46; Non-invasive ventilation is applied in 15&#37; of cases while High-flow nasal cannula in 14&#37;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The Portuguese Society of Pulmonology published back in 26th March recommendations on the use of NIRT in COVID-19&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However it is not known how NIRT are currently being applied in Portugal&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The 36th Congress of the Portuguese Society of Pulmonology took place 12&#8211;14th November 2020&#46; Analyzing the published abstracts&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> we retrieved 9 describing the experience of treating patients with COVID-19 related acute respiratory failure who were admitted to 7 public hospitals between March and August 2020&#46; Total number of patients studied was 1594 from 1 Hospital in the North of Portugal&#44; 2 in the centre and 4 in Lisbon region&#46; Mean age was 69 years and only three series reported mean PaO2&#58;FiO2 ratios&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">All except one Hospital &#40;from the centre of Portugal&#41; reported NIRT usage&#46; Mean NIRT use was 16&#46;3&#37; &#40;minimum 5&#37; in an infectious disease department to 48&#46;4&#37; in a Pulmonology Department&#41;&#46; Only 3 Hospitals reported ventilation modes&#59; with two favoring CPAP &#40;usage of 53&#46;9&#37; and 87&#46;8&#37; of NIRT&#41; and one favoring Bi-Level &#40;usage of 97&#46; 4&#37; of NIRT&#41;&#46; Only two reports &#40;one from a Hospital in the Northern region and one from Lisbon&#41; described the pressure levels used&#46; Two hospitals &#40;from Lisbon region&#41; reported use of High Flow Nasal cannula &#40;in 3&#37; and 4&#37; of all the admitted patients&#41;&#46; Only 3 Hospitals reported success rates of NIRT&#44; with a mean of 59&#37; &#40;from only 23&#37; in the hospital that used Bi-Level mode to 78&#37; in the hospital that preferentially used CPAP&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In only one Hospital was the Pulmonology Department the frontline service to support patients with COVID-19 and acute respiratory failure&#46; This had the highest NIRT success rate&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">These results suggest that current practices involving NIRT in COVID-19 in Portugal are really heterogeneous&#44; with limited descriptions of the interventions and outcomes&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">There should be a National Audit to monitor use of NIRT in the real world and the Pulmonology specialty should be the driver&#44; pushing for an increased number of Respiratory Intermediate care Units with the right protocols and equipoise&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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