CONCLUSION
Through official documents of the Ministry of Health of Brazil, based on
the regulations of the World Health Organization, it is recommended that
hospitalized patients diagnosed with SARS and that the cases identified
with the symptoms of severity have admitted to an intensive care bed.
These symptoms are persistent hemodynamic instability (blood pressure
that did not respond to volume replacement (30 mL/kg in the first 3
hours), indicating the use of vasoactive amine (example: norepinephrine,
dopamine, adrenaline), signs and symptoms of respiratory failure,
including hypoxemia (PaO2 below 60 mmHg) requiring oxygen
supplementation to maintain arterial oxygen saturation above 90%,
progressing to other organic disorders, such as acute renal failure and
neurological dysfunction.
It was defined that the clinical criteria for hospital discharge should
take into account the improvement of the clinical picture, the absence
of tachydyspnea and hypoxia, the absence of O2 supplementation for at
least 24 hours, the hemodynamic stability, the good acceptance of the
oral route and the absence of fever. The reappearance of tachycardia,
recurrence of fever, worsening of the general condition, or respiratory
symptoms indicate the need for an immediate return of the child who has
already has discharged from health services.
Prophylactic use of antibiotics was not recommended, but use should be
considered based on the suspicion of associated bacterial infection. It
is recommended that critically ill patients, without Covid-19
etiological confirmation, be managed according to the SARS protocol and
that supportive treatment should focus on reversing hypoxemia.
Mechanical ventilation indication should follow pediatric protective
ventilation protocols in patients with SARS.