Objective: To describe clinical characteristics, resource use, outcomes, and to identify predictors of in-hospital mortality of patients with COVID-19 admitted to the intensive care unit. Methods: Retrospective single-center cohort study conducted at a private hospital in São Paulo (SP), Brazil. All consecutive adult (≥18 years) patients admitted to the intensive care unit, between March 4, 2020 and February 28, 2021 were included in this study. Patients were categorized between survivors and non-survivors according to hospital discharge. Results: During the [...] ABSTRACT Objective: To describe clinical characteristics, resource use, outcomes, and to identify predictors of in-hospital mortality of patients with COVID-19 admitted to the intensive care unit. Methods: Retrospective single-center cohort study conducted at a private hospital in São Paulo (SP), Brazil. All consecutive adult (≥18 years) patients admitted to the intensive care unit, between March 4, 2020 and February 28, 2021 were included in this study. Patients were categorized between survivors and non-survivors according to hospital discharge. Results: During the

Background: Out-of-hospital cardiac arrests (OHCAs) predominantly occur in residential settings, often witnessed by children who could act as first responders. The World Health Organization (WHO) supports the Kids Save Lives (KSL) initiative, recommending basic life support (BLS) training for children aged ≥11 years. However, disparities in BLS education persist globally, particularly in low-resource regions where socioeconomic barriers, such as school type, malnutrition, and limited infrastructure, hinder implementation. Younger children (aged <11 years) face additional challenges due to physical limitations (eg, height, weight, and grip strength), which may compromise their ability to achieve adequate chest compression depth. While gamified learning has shown promise in improving BLS engagement and skill acquisition, its efficacy across diverse socioeconomic groups remains understudied. Objective: This study aimed to compare cardiopulmonary resuscitation (CPR) performance (compression depth, rate, and recoil) between public and private school students following a game-based BLS intervention and evaluate the feasibility of a serious game (Kids Save Hearts) in improving BLS knowledge and irrespective of socioeconomic background. Methods: We conducted an observational cohort study with 336 students aged 7‐17 years from 10 public and 10 private schools in Brazil (April to November 2022). Participants received 40 minutes of video-based CPR training (American Heart Association CPR in Schools) followed by 10 minutes of gamified training using the Children Save Hearts serious game (SG). CPR quality was assessed via quality of cardiopulmonary resuscitation (QCPR) scores (Laerdal QCPR manikin), measuring compression depth (mm), compression rate (per minute), and chest recoil. Anthropometric data (height, weight, and grip strength) and socioeconomic indicators (school type) were collected. Nonparametric tests (Mann-Whitney U and chi-square tests ) and multivariate regression (SPSS v27.0; IBM Corp) were used to analyze associations between demographics, physical characteristics, and CPR performance. Results: Older students (11‐17 years) outperformed younger peers (7‐10 years) in median compression depth (48 mm vs 37 mm; P <.001) and overall QCPR scores (84 vs 42, P <.001). Private school students had higher grip strength (24.92 vs 21.48 g/cm²; P =.001), but school type did not significantly affect CPR quality. Postintervention SG scores improved universally ( P <.001), with no age or socioeconomic disparities. Multivariate analysis identified age ( P <.001), height ( P <.001), and grip strength ( P <.001) as independent predictors of high QCPR scores (≥70). Conclusions: Age and physical development were stronger determinants of CPR quality than socioeconomic factors. The game-based intervention effectively improved BLS knowledge and skills across all participants, demonstrating its potential as an equitable training tool. These findings support the scalability of gamified BLS programs in resource-limited settings.

Cardiovascular diseases are leading causes of death and morbidity worldwide. CPR and early defibrillation significantly enhance survival rates. Serious Games (SG) improve learning through entertainment. Current strategies target Cardiopulmonary resuscitation for communities and schoolchildren, but none have been validated for children in low-to-middle-income settings. The SG Children Save Hearts, developed in Brazil, teaches the five resuscitation steps according to International Liaison Committee on Resuscitation 2020 guidelines and requires formal usability assessment. The study aimed to evaluate the usability of SG Children Save Hearts among IT and healthcare professionals using the System Usability Scale (SUS). The usability test was conducted in August 2022 in the university's IT department. The game was developed targeting schoolchildren aged 7 to 17. Categorical variables as absolute and relative frequencies, while continuous variables were presented as median with interquartile range (IQR). Normality was assessed using the Shapiro-Wilk test. Comparisons between IT and healthcare professionals were made using the independent t-test for normal distributions or the Mann-Whitney U test for non-normal distributions. We included 17 volunteers with a mean age of 22 years (IQR 20-26). All participants played the game and completed a 10-question survey on its usability using a Likert-type scale. The final grade was converted to a 0 to 100 scale, with a grade above 70 considered acceptable for a minimum viable product. The mean SUS score was 75 (IQR 72.5-87.5). Healthcare professionals gave higher grades to all five domains compared to IT professionals. The average time spent playing the game was 3.2 minutes. Novel technologies have shown promising results for CPR teaching using active teaching methods, but face challenges in developing countries, such as language barriers, device acquisition, cultural differences, and technical support. To our knowledge, this is the first SG developed in portuguese for brazilian schoolchidren. Despite some usability issues, the SG Children Save Hearts is considered adequate for teaching CPR to schoolchildren in Brazil.

Highlights We compared characteristics between patients admitted during the first and second waves. There were 1,427 intensive care unit patients with COVID-19: 421 (first wave) and 1,006 (second wave). The patients in the second wave were younger and less severely ill at the time of intensive care unit admission. Patients exhibited similar mortality rates and need for invasive organ support. ABSTRACT Objective To describe and compare the clinical characteristics and outcomes of patients admitted to intensive care units during the

Objective: To investigate the impact of intensive care unit admission during medical handover on mortality. Methods: Post-hoc analysis of data extracted from a prior study aimed at addressing the impacts of intensive care unit readmission on clinical outcomes. This retrospective, single-center, propensity-matched cohort study was conducted in a 41-bed general open-model intensive care unit. Patients were assigned to one of two cohorts according to time of intensive care unit admission: Handover Group (intensive care unit admission between 6:30 am [...] ABSTRACT Objective: To investigate the impact of intensive care unit admission during medical handover on mortality. Methods: Post-hoc analysis of data extracted from a prior study aimed at addressing the impacts of intensive care unit readmission on clinical outcomes. This retrospective, single-center, propensity-matched cohort study was conducted in a 41-bed general open-model intensive care unit. Patients were assigned to one of two cohorts according to time of intensive care unit admission: Handover Group (intensive care unit admission between 6:30 am

Highlights 43.4% of the cohort developed acute kidney injury. D-dimer and fibrinogen levels were high in both groups. Rotational thromboelastometry data were similar between groups. Serum levels of antithrombin activity and protein C were lower in patients who developed acute kidney injury. Objective The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who