Alprostadil associado a heparina de baixo peso molecular para o tratamento da isquemia de membros causada por SARS-CoV2

CorrespondenceJulio Cesar Gali Filho JJMED Rua Caracas, 418 CEP 18046-718 - Sorocaba (SP) - Brasil Tel.: +55 (15) 3233-4171 E-mail: juliogalifilho@gmail.com

Author informationMABMF - Cirurgia Vascular discipline preceptor, Pontifícia Universidade Católica de São Paulo (PUC-SP). EGDJ - Medical preceptor, Universidade de Vila Velha (UVV). JVOM - Board-certified surgeon in Angioradiologia and Cigurgia Endovascular, Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV). FL - Medical residency coordinator, Cirurgia Vascular, Pontifícia Universidade Católica de São Paulo (PUC-SP). JAC - Tenured professor, Cirurgia Vascular, Pontifícia Universidade Católica de São Paulo (PUC-SP). JCG - Professor, Cirurgia, Pontifícia Universidade Católica de São Paulo (PUC-SP). WBY - Tenured professor, Cirurgia Vascular, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP). JCGF - Chief of Research and Development, JJMED.

Author contributionsConception and design: MABMF Analysis and interpretation: MABMF, EGDJ, JCGF Data collection: MABMF, JVOM, FL Writing the article: MABMF, JCG, JCGF Critical revision of the article: MABMF, EGDJ, JVOM, FL, JAC, WBY, JCG, JCGF Final approval of the article*: MABMF, EGDJ, JVOM, FL, JAC, WBY, JCG, JCGF Statistical analysis: N/A. Overall responsibility: MABMF, JCGF *All authors have read and approved of the final version of the article submitted to J Vasc Bras.

EXAM	Mar-21 (DAY 1)	Mar-24 (DAY 4) ^* * intubation, †LMWH full dosage, ‡dilated pupils; §ICU discharge.	Mar-25 (DAY 5)	Mar-29 (DAY 9)	Mar-30 (DAY 10)	Mar-31 (DAY 11)†	Apr-1 (DAY 12)	Apr-3 (DAY 14)‡	Apr-4 (DAY 15)	Apr-13 (DAY 24)	Apr-18 (DAY 29)§
C-REACTIVE PROTEIN		15.1	26.6	4.8	2.5	13.5	27.2	15.5	17.1	11.8	16.9
D-DIMER	0.3		0.7	2.7				0.8		2.6	1.4
BLOOD UREA	37		23	63	82	90	96	81	78	74	42
CREATININE	1		1.1	1.4	1.3	1.2	1.2	1.2	1.2	0.8	0.6
CREATINE PHOSPHOKINASE			60	327		2757	3329	2767	1901	170	43
INR (international normalized ratio)			1.06	0.96	0.98	1.03	1.21	1.09	1.07	1.13	1.17
PROTHROMBIN TIME			13.8s	12.8s	13.1s	13.5s	15.3s	14.2s	13.9s	14.6s	15.0s
APTT (activated partial thromboplastin time)			38.3s	36.5s	30.6s	45.8s	53.6s	53.6s	50.6s	31.1s	49.0s
APTT pool ratio			1.10	1.05	0.88	1.32	1.54	1.54	1.45	0.93	1.46
LACTIC DEHYDROGENASE	315		618	375			412	341	338		243
FERRITIN				420			580				628
PLATELET COUNT	118K	130K	197K	217K	186K	228K	227K	267K	331K	298K	316K
ERYTHROCYTE COUNT	4.8	4.4	4.53	4.04	3.77	4.25	3.78	3.28	3.28	3.23	3.03
HEMOGLOBIN	12.5	11.4	11.8	10.5	9.7	11	9.6	8.5	8.5	8.5	8.2
HEMATOCRIT	38.2	35.2	38.3	34.8	31.7	34.8	31.2	27.3	27.2	27	24.5
LEUCOCYTE COUNT	5910	4520	14380	10840	9450	14650	11590	10520	10850	11880	11830
NEUTROPHIL COUNT	4630	3313	12511	9843	8316	12409	9817	9005	9765	8910	9346
LYMPHOCYTE COUNT	1010	868	288	336	473	894	707	1084	326	832	1183
EOSINOPHIL COUNT	0	9	0	0	0	147	0	105	109	950	473
OXYGEN SATURATION (%)	96.30%	94.70%	99.60%	97.10%	95.20%	91.90%	96.80%	97.00%	95.60%	93.20%	96.80%
BLOOD pH	7.397	7.461	7.194	7.267	7.561	7.535	7.560	7.479	7.475	7.521	7.474

TEST	REFERENCE NORMAL RANGE
C-Reactive Protein	< 0.5 mg/dL
D-dimer	< 0.5 ug/mL
Blood Urea	16.6-48.5 mg/dL
Creatinine	0.5-0.9 mg/dL
Creatine Phosphokinase	26-192 U/L
INR (international normalized ratio)	0.8-1.1
Prothrombin time	11-15 seconds
APTT	30-50 seconds
APTT pool ratio	< 1.26
Lactic Dehydrogenase	133-225 U/L
Ferritin	13-150 ng/mL
Hemoglobin	10.90-17.50 g/dL
Hematocrit	34-52%
Leucocyte count	4000-10000 /uL
Neutrophil count	1800-7200 /uL
Lymphocyte count	800-3500 /uL
Eosinophil count	40-400 /uL
Oxygen Saturation (%)	> 96%
Blood pH	7.370-7.450

[1] Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

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Alprostadil associado a heparina de baixo peso molecular para o tratamento da isquemia de membros causada por SARS-CoV2

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