Palavras-chave
Mortalidade
Terapia intensiva
Como Citar
Resumo
Introdução: Nas Unidades de Terapia Intensiva (UTI), a falência circulatória, manifestada como choque, é uma condição crítica que exige intervenção imediata. As Drogas Vasoativas (DVAs) constituem o pilar do suporte hemodinâmico para restaurar o tônus vascular e manter a pressão arterial. Embora essenciais, o uso dessas medicações é comum — afetando cerca de 40% dos pacientes internados em UTI — e está inevitavelmente ligado a desfechos clínicos mais sombrios e a um aumento significativo da mortalidade, refletindo a gravidade implacável da doença subjacente. Objetivos: O objetivo principal deste estudo foi avaliar, por meio de uma revisão sistemática da literatura, a associação entre o uso de drogas vasoativas e a mortalidade em pacientes adultos internados em UTI. Metodologia: Este estudo seguiu as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. A pergunta de pesquisa foi estruturada usando a estratégia PICO. A busca foi realizada nas bases PubMed/MEDLINE, Embase, Scopus e Web of Science, incluindo estudos publicados nos últimos cinco anos (2020 a 2025). Os critérios de elegibilidade focaram em estudos observacionais e ensaios clínicos com adultos na UTI que utilizaram DVAs e avaliaram mortalidade. No total, 23 estudos compuseram a síntese final. Devido à significativa heterogeneidade entre os delineamentos e as populações, optou-se por uma síntese narrativa dos achados. Conclusão: A revisão sistemática confirma que o uso de DVAs é um preditor robusto e independente de aumento da mortalidade em pacientes críticos em diversas populações da UTI. A intensidade do suporte vasoativo, quantificada por escores como o Vasoactive Inotropic Score (VIS) e o Índice de Resposta da Pressão Arterial (BPRI), correlaciona-se diretamente com o pior prognóstico. Diante desses achados, o monitoramento rigoroso da dose e da resposta hemodinâmica às DVAs é fundamental para a estratificação de risco e para guiar a otimização terapêutica.
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Copyright (c) 2025 Gabriela Lima da Silva