{"id":3694,"date":"2021-03-02T09:00:00","date_gmt":"2021-03-02T09:00:00","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/uncategorized\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\/"},"modified":"2021-09-16T17:50:01","modified_gmt":"2021-09-16T17:50:01","slug":"afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/artigoscomentados\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\/","title":{"rendered":"Afinal, endoscopia digestiva alta produz mesmo aerossol?"},"content":{"rendered":"

Artigo: Aerosols Produced by Upper Gastrointestinal Endoscopy: A Quantitative Evaluation<\/h2>\n

Am J Gastroenterol 2021;116:202\u2013205. https:\/\/doi.org\/10.14309\/ajg.0000000000000983<\/span><\/p>\n

H\u00e1 alguns meses, aqui no Endoscopia Terap\u00eautica, trouxemos uma breve discuss\u00e3o sobre aeross\u00f3is e transmissibilidade do Sars-Cov2 na pr\u00e1tica endosc\u00f3pica.\u00a0<\/span><\/p>\n

Como colocado no post anterior (<\/span>veja mais<\/span><\/a>), at\u00e9 recentemente, a <\/span>endoscopia digestiva<\/span> estava fora da lista de procedimentos geradores de aeross\u00f3is (AGP). Na verdade, at\u00e9 o momento da reda\u00e7\u00e3o deste artigo, o site do CDC, Centers for Disease Control and Prevention (atualizado em 07 jan 21), n\u00e3o inclui a endoscopia digestiva na lista de AGPs, embora reconhe\u00e7a que a lista n\u00e3o \u00e9 definitiva (figura 1). <\/span><\/p>\n

\"Afinal,<\/a>

Figura 1- Procedimentos geradores de aerossol, segundo o CDC. Excerto de https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/faq.html#Transmission<\/p><\/div>\n

 <\/p>\n

At\u00e9 o momento, havia apenas a evid\u00eancia de dissemina\u00e7\u00e3o bacteriana demonstrada por culturas de amostras de <\/span>face shields<\/span><\/i> usadas por endoscopistas.\u00a0<\/span><\/p>\n

Uma correspond\u00eancia publicada em outubro de 2020 no American Journal of Gastroenterology, no entanto, trouxe maior consist\u00eancia ao que j\u00e1 \u00e9 empiricamente assumido pela maior parte dos especialistas.\u00a0<\/span><\/p>\n

O experimento quantificou a gera\u00e7\u00e3o de part\u00edculas de aerossol observada durante 105 endoscopias digestivas altas consecutivas, em compara\u00e7\u00e3o com um grupo controle no qual uma endoscopia<\/a> foi simulada (90 simula\u00e7\u00f5es). Um artefato pl\u00e1stico c\u00fabico, usado no servi\u00e7o como forma de limitar a transmiss\u00e3o associada aos procedimentos, foi utilizado. O artefato conta com duas pequenas passagens que d\u00e3o acesso ao endosc\u00f3pio e a um contador \u00f3ptico de part\u00edculas sens\u00edvel a part\u00edculas entre 0,3 e 10 mm (figura 2).<\/span><\/p>\n

\"\"<\/a>

Ilustra\u00e7\u00e3o da posi\u00e7\u00e3o do endosc\u00f3pio e contador de part\u00edculas em artefato pl\u00e1stico utilizado no estudo. Am J Gastroenterol 2021;116:202\u2013205. https:\/\/doi.org\/10.14309\/ajg.0000000000000983<\/p><\/div>\n

As contagens foram realizadas antes, durante e ap\u00f3s a realiza\u00e7\u00e3o das endoscopias e em tempos equivalentes no grupo controle, e os valores comparados.\u00a0<\/span><\/p>\n

O incremento de part\u00edculas entre as amostras \u201cantes\u201d e \u201cdurante\u201d foi maior no grupo endoscopia do que no grupo controle (P <0,001), bem como \u201cantes\u201d e \u201cap\u00f3s\u201d o procedimento (P<0,001). O mesmo resultado foi observado na contagem absoluta de part\u00edculas \u201cdurante\u201d no grupo endoscopia (P=0,006), quando comparado ao grupo controle.\u00a0<\/span><\/p>\n

No grupo endoscopia, 60 pacientes foram considerados como apresentando aerossoliza\u00e7\u00e3o elevada (>2x desvio padr\u00e3o do grupo controle). \u00cdndice de massa corporal (IMC) e eructa\u00e7\u00e3o foram fatores significantes relacionados ao aumento da aerossoliza\u00e7\u00e3o durante a endoscopia na an\u00e1lise univariada (P=0,020 e 0,018, respectivamente) e na an\u00e1lise de regress\u00e3o log\u00edstica multivariada (P=0,033 e 0,025, respectivamente).\u00a0<\/span><\/p>\n

Os autores ressaltam a necessidade de uma seda\u00e7\u00e3o adequada e de insufla\u00e7\u00e3o cuidadosa para minimizar os riscos associados \u00e0 eructa\u00e7\u00e3o. Sugerem ainda a ado\u00e7\u00e3o de artefato semelhante ao usado no estudo para limitar a dissemina\u00e7\u00e3o das part\u00edculas no ambiente. Ainda, consideram sua amostra relativamente pequena e a necessidade de estudos com maior n\u00famero de pacientes. Embora haja diferen\u00e7a estat\u00edstica entre os grupos quanto \u00e0 idade m\u00e9dia e aos antecedentes cl\u00ednicos, os autores n\u00e3o fazem men\u00e7\u00e3o em sua breve discuss\u00e3o.\u00a0<\/span><\/p>\n

Embora tenha fragilidades, o estudo refor\u00e7a a necessidade de manuten\u00e7\u00e3o dos cuidados, utiliza\u00e7\u00e3o de equipamentos de prote\u00e7\u00e3o individual e aten\u00e7\u00e3o \u00e0 possibilidade de contamina\u00e7\u00e3o por via a\u00e9rea, seja em casos suspeitos, sabidamente positivos e mesmo em assintom\u00e1ticos sadios.<\/span><\/p>\n

Posts anteriores relacionados:<\/span><\/p>\n

Transmiss\u00e3o do novo coronav\u00edrus<\/strong><\/a><\/p>\n

Got\u00edculas, aeross\u00f3is e transmiss\u00e3o do coronav\u00edrus<\/strong><\/a><\/p>\n

Como citar este artigo:<\/h3>\n

Rodrigues R. Afinal, endoscopia digestiva alta produz mesmo aerossol?. Endoscopia Terap\u00eautica; 2021. Dispon\u00edvel em:\u00a0https:\/\/endoscopiaterapeutica.net\/pt\/artigoscomentados\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\/<\/span><\/p>\n

Acesse o <\/span>Endoscopia Terap\u00eautica<\/span><\/a> para tomar contato com mais <\/span>artigos comentados<\/span><\/a>, <\/span>assuntos gerais<\/span><\/a>, <\/span>casos cl\u00ednicos<\/span><\/a>, <\/span>quizzes<\/span><\/a>, <\/span>classifica\u00e7\u00f5es<\/span><\/a> e mais!<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Artigo: Aerosols Produced by Upper Gastrointestinal Endoscopy: A Quantitative Evaluation Am J Gastroenterol 2021;116:202\u2013205.…<\/p>\n","protected":false},"author":4390,"featured_media":3695,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[142],"tags":[],"ano":[262],"tipo":[159],"volume":[263],"class_list":["post-3694","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-artigoscomentados","ano-262","tipo-outros","volume-volume-i"],"yoast_head":"\nAfinal, endoscopia digestiva alta produz mesmo aerossol? • Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/pt\/artigoscomentados\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Afinal, endoscopia digestiva alta produz mesmo aerossol?\" \/>\n<meta property=\"og:description\" content=\"Artigo: Aerosols Produced by Upper Gastrointestinal Endoscopy: A Quantitative Evaluation Am J Gastroenterol 2021;116:202\u2013205.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/artigoscomentados\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\/\" \/>\n<meta property=\"og:site_name\" content=\"Endoscopia Terapeutica\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/endoscopiaterapeutica\" \/>\n<meta property=\"article:published_time\" content=\"2021-03-02T09:00:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-09-16T17:50:01+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/03\/aerossol.png\" \/>\n\t<meta property=\"og:image:width\" content=\"702\" \/>\n\t<meta property=\"og:image:height\" content=\"312\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Rodrigo Rodrigues\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Rodrigo Rodrigues\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/artigoscomentados\\\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/artigoscomentados\\\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\\\/\"},\"author\":{\"name\":\"Rodrigo Rodrigues\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#\\\/schema\\\/person\\\/d9023eb331b3c93697a869888659be90\"},\"headline\":\"Afinal, endoscopia digestiva alta produz mesmo aerossol?\",\"datePublished\":\"2021-03-02T09:00:00+00:00\",\"dateModified\":\"2021-09-16T17:50:01+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/artigoscomentados\\\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\\\/\"},\"wordCount\":654,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/artigoscomentados\\\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2021\\\/03\\\/aerossol.png\",\"articleSection\":[\"Artigos Comentados\"],\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/artigoscomentados\\\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/artigoscomentados\\\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\\\/\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/artigoscomentados\\\/afinal-endoscopia-digestiva-alta-produz-mesmo-aerossol\\\/\",\"name\":\"Afinal, endoscopia digestiva alta produz mesmo aerossol? 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