Purpose The aim of this study was to describe the changes in respiratory system compliance and other measures of respiratory mechanics associated with peritoneal insufflation (12 mmHg pressure) with carbon dioxide (PNP12) and 20°Trendelenburg positioning (TDG20) in pediatric patients undergoing laparoscopic surgery for abdominal cryptorchidism.Methods Twelve subjects with abdominal cryptorchidism undergoing orchiopexy were enrolled in the study. General anesthesia was conducted with sevoflurane/O 2 /air, fentanyl, and rocuronium. Pressure-controlled ventilation with a peak inspiratory pressure (PIP) of 10-15 cm H 2 O and a positive end-expiratory pressure of 5 cm H 2 O was titrated to achieve a tidal volume (VT/kg) of 6-10 mLÁkg -1 and end-tidal carbon dioxide (EtCO 2 ) of 35-40 mmHg. Adjustments of PIP and respiratory rate (RR) were made to maintain the initial VT/kg and EtCO 2 \ 50 mmHg. Measurements of weight-corrected dynamic compliance (Cdyn/kg), VT/kg, and EtCO 2 were recorded at baseline, after PNP12, at TDG20, and again after deflation and return to the level position. Results Adjustments in PIP were required in all subjects to maintain the target VT/kg. The Cdyn/kg decreased 42% (95% confidence interval [CI]: 30 to 51; P \ 0.001) after PNP12, and it remained below baseline until deflation. The Author contributions Victor M. Neira was the principal investigator for the study. Victor M. Neira, Thomas Kovesi, Luis Guerra, Nicholas Barrowman, and William Splinter contributed to the study design. Victor M. Neira and Luis Guerra contributed to data acquisition. Thomas Kovesi, Maria Campos, and Nicholas Barrowman contributed to the data analysis. Victor M. Neira, Thomas Kovesi, Luis Guerra, and Maria Campos contributed to data interpretation. Victor M. Neira was the principal author of the manuscript with contributions from Thomas Kovesi, Maria Campos, Luis Guerra, Nicholas Barrowman, and William Splinter. 123Can J Anesth/J Can Anesth (2015) 62:798-806 DOI 10.1007/s12630-015-0369-0 TDG20 caused only minimal additional reductions in Cdyn/kg (10% decrease; 95% CI: 0 to 19; P = 0.048). The VT/kg decreased 42% (95% CI: 31 to 52; P = 0.048) with PNP12, and after TDG20, it decreased a further 10% (95% CI: 4 to 19; P = 0.038). After deflation, the VT/kg increased by 56% (95% CI: 28 to 90; P = 0.001) and was then adjusted back to the initial values. Conclusion The PNP12 significantly decreases Cdyn/kg and VT/kg in pediatric patients. The use of TDG20 produces a relatively minor additional impact in respiratory mechanics. This study emphasizes the need to adjust ventilator settings to maintain normal gas exchange during this procedure. RésuméObjectif L'objectif de cette étude était de décrire les changements de compliance du système respiratoire et d'autres mesures de la mécanique respiratoire associés à une insufflation péritonéale (pression de 12 mmHg) à l'aide de dioxyde de carbone (PNP12) et d'une position de Trendelenburg à 20°(TDG20) chez les patients pédiatriques subissant une chirurgie par laparoscopie...

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Introduction The effects, severity, and prognosis of COVID-19 infections do not follow a linear pattern in different locations, but change according to the epidemiological data and social issues in each region. Aims The purpose of the current study is to provide the clinical and epidemiological standard of the population affected by COVID-19 in the city of Juiz de Fora, MG to better understand the disease and its risk factors, in order to enable more appropriate conduct for patients. Methods A retrospective observational study was carried out from March to August of 2020, with 266 participants admitted to the emergency department of the Instituto de Clínicas e Cirurgia de Juiz de Fora—Hospital Monte Sinai. Data were tabulated, analyzed, and classified according to the outcome using an ordinal regression model. Results Among the 266 admitted patients, the most common findings were ground-glass opacifications on chest CT (78.8%), cough (75.6%), fever (58.4%), and rhinorrhea (34.5%). There were greater severity and greater need for hospitalization and admission to the ICU in patients who were male, tachypneic at the time of admission, with older age, and with underlying diseases. Conclusion Collected data allowed for a better understanding of the disease, its severity criteria, and its pattern of affection in Juiz de Fora, MG. More studies based on the analysis of the behavior of COVID-19 in different regions must be carried out, to improve treatment and support to local populations.