Image in Cardiology
Diagnosis and management of pulmonary embolism in critical situations: A cardiac challenge
Embolia pulmonar em pacientes críticos: desafio cardíaco
Juan Caro-Codón
, Teresa López-Fernández, Ángel Sánchez-Recalde, Silvia Valbuena-López, Raúl Moreno, José Luis López-Sendón
Autor para correspondência
Serviço de Cardiologia, Hospital Universitario La Paz, Madrid, Spain
Lido
5033
Vezesque se leu este artigo
1718
Total PDF
3315
Total HTML
Compartilhar estatísticas
array:25 [ "pii" => "S0870255115002486" "issn" => "08702551" "doi" => "10.1016/j.repc.2015.06.009" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "718" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2015" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2015;34:703-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2290 "formatos" => array:3 [ "EPUB" => 185 "HTML" => 1526 "PDF" => 579 ] ] "Traduccion" => array:1 [ "en" => array:20 [ "pii" => "S2174204915002627" "issn" => "21742049" "doi" => "10.1016/j.repce.2015.11.009" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "718" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2015;34:703-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2186 "formatos" => array:3 [ "EPUB" => 150 "HTML" => 1652 "PDF" => 384 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Diagnosis and management of pulmonary embolism in critical situations: A cardiac challenge" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "703" "paginaFinal" => "704" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Embolia pulmonar em pacientes críticos: desafio cardíaco" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 751 "Ancho" => 764 "Tamanyo" => 138333 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pre- (A) and post-intervention (B) angiography of the right pulmonary artery. Abundant thrombotic material was retrieved (C). Chest radiograph (D) showed wedge-shaped pleural based opacities (“Hampton's hump”).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Caro-Codón, Teresa López-Fernández, Ángel Sánchez-Recalde, Silvia Valbuena-López, Raúl Moreno, José Luis López-Sendón" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Juan" "apellidos" => "Caro-Codón" ] 1 => array:2 [ "nombre" => "Teresa" "apellidos" => "López-Fernández" ] 2 => array:2 [ "nombre" => "Ángel" "apellidos" => "Sánchez-Recalde" ] 3 => array:2 [ "nombre" => "Silvia" "apellidos" => "Valbuena-López" ] 4 => array:2 [ "nombre" => "Raúl" "apellidos" => "Moreno" ] 5 => array:2 [ "nombre" => "José Luis" "apellidos" => "López-Sendón" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255115002486" "doi" => "10.1016/j.repc.2015.06.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115002486?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915002627?idApp=UINPBA00004E" "url" => "/21742049/0000003400000011/v2_201703180236/S2174204915002627/v2_201703180236/en/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S0870255115002280" "issn" => "08702551" "doi" => "10.1016/j.repc.2015.03.022" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "698" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2015;34:705-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2097 "formatos" => array:3 [ "EPUB" => 166 "HTML" => 1365 "PDF" => 566 ] ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta ao Editor</span>" "titulo" => "Comentário a estudo de custo‐efetividade de rivaroxabano para prevenção de acidente vascular cerebral em doentes com fibrilhação auricular em Portugal" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "705" "paginaFinal" => "706" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Comment on “Cost‐effectiveness of rivaroxaban for stroke prevention in atrial fibrillation in the Portuguese setting”" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luís Silva Miguel" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Luís" "apellidos" => "Silva Miguel" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204915002111" "doi" => "10.1016/j.repce.2015.09.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915002111?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115002280?idApp=UINPBA00004E" "url" => "/08702551/0000003400000011/v1_201511060141/S0870255115002280/v1_201511060141/pt/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S0870255115002322" "issn" => "08702551" "doi" => "10.1016/j.repc.2015.02.006" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "702" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2015;34:701-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2979 "formatos" => array:3 [ "EPUB" => 184 "HTML" => 2128 "PDF" => 667 ] ] "pt" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagem em Cardiologia</span>" "titulo" => "Aneurisma gigante e intratável percutaneamente da coronária direita" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "701" "paginaFinal" => "702" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Giant right coronary aneurysm untreatable by percutaneous intervention" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 700 "Ancho" => 700 "Tamanyo" => 71634 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronária direita com aneurisma gigante no terço médio, envolvendo porção proximal de <span class="elsevierStyleItalic">stent</span> com trombo luminal.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Bruno Marmelo, Anne Delgado, Davide Moreira, João Pipa, Pedro Ferreira, Oliveira Santos" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Bruno" "apellidos" => "Marmelo" ] 1 => array:2 [ "nombre" => "Anne" "apellidos" => "Delgado" ] 2 => array:2 [ "nombre" => "Davide" "apellidos" => "Moreira" ] 3 => array:2 [ "nombre" => "João" "apellidos" => "Pipa" ] 4 => array:2 [ "nombre" => "Pedro" "apellidos" => "Ferreira" ] 5 => array:2 [ "nombre" => "Oliveira" "apellidos" => "Santos" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204915002068" "doi" => "10.1016/j.repce.2015.09.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915002068?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115002322?idApp=UINPBA00004E" "url" => "/08702551/0000003400000011/v1_201511060141/S0870255115002322/v1_201511060141/pt/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Diagnosis and management of pulmonary embolism in critical situations: A cardiac challenge" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "703" "paginaFinal" => "704" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Juan Caro-Codón, Teresa López-Fernández, Ángel Sánchez-Recalde, Silvia Valbuena-López, Raúl Moreno, José Luis López-Sendón" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Juan" "apellidos" => "Caro-Codón" "email" => array:1 [ 0 => "juancarocd@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Teresa" "apellidos" => "López-Fernández" ] 2 => array:2 [ "nombre" => "Ángel" "apellidos" => "Sánchez-Recalde" ] 3 => array:2 [ "nombre" => "Silvia" "apellidos" => "Valbuena-López" ] 4 => array:2 [ "nombre" => "Raúl" "apellidos" => "Moreno" ] 5 => array:2 [ "nombre" => "José Luis" "apellidos" => "López-Sendón" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Serviço de Cardiologia, Hospital Universitario La Paz, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Embolia pulmonar em pacientes críticos: desafio cardíaco" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 750 "Ancho" => 526 "Tamanyo" => 67804 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Mid-esophageal right ventricular inflow-outflow view before (A, with right ventricular dilatation and severe tricuspid regurgitation) and after percutaneous thrombectomy (B, with normal size right ventricle and resolution of tricuspid regurgitation).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 40-year-old woman was admitted to the intensive care unit after extensive thoracic burns. During surgical debridement, she experienced rapidly progressive hypoxemia and hypotension requiring high-dose vasopressors, and oxygen saturation remained low despite 100% inspired oxygen concentration. Three-dimensional transesophageal echocardiography was performed, which showed a large thrombus in the right pulmonary artery, extending from the main pulmonary artery bifurcation (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 1</a>). It also revealed right ventricular dilatation and severe tricuspid regurgitation (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 2</a>A). Given the high bleeding risk associated with recent surgery, a decision was made to perform percutaneous thrombectomy with low-dose intra-arterial fibrinolysis instead of systemic full-dose thrombolysis. Pre-intervention angiography demonstrated a large filling defect in the right pulmonary artery with impaired distal flow (<a class="elsevierStyleCrossRef" href="#fig0025">Figure 3</a>A). Abundant thrombotic material was obtained (<a class="elsevierStyleCrossRef" href="#fig0025">Figure 3</a>C) and significant improvement in pulmonary circulation was noted (<a class="elsevierStyleCrossRef" href="#fig0025">Figure 3</a>B). After the procedure, the patient experienced a dramatic improvement in hemodynamic and respiratory parameters, enabling discontinuation of vasopressors and the use of lower inspired oxygen concentration. Chest radiography demonstrated wedge-shaped pleural based opacities (the “Hampton's hump” sign, <a class="elsevierStyleCrossRef" href="#fig0025">Figure 3</a>D). Follow-up echocardiography performed 48 hours later showed resolution of right ventricular dilatation and tricuspid regurgitation (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 2</a>B).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Transesophageal echocardiography is useful in the diagnosis of pulmonary embolism in critically ill patients. It may show signs of right ventricular overload and enables direct visualization of thrombi in the right heart or the pulmonary artery. High-risk patients (e.g. those with hemodynamic instability) usually benefit from thrombolytic therapy, but percutaneous techniques are a reasonable alternative when there is significant risk of major bleeding.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0010" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-04-16" "fechaAceptado" => "2015-06-07" "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1250 "Ancho" => 1287 "Tamanyo" => 148017 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Mid-esophageal orthogonal views of the superior vena cava (SVC), ascending aorta (AO) and right pulmonary artery. Three-dimensional (3D) transesophageal echocardiography shows a large thrombus in the right pulmonary artery (white arrow), extending from the main pulmonary artery bifurcation. 3D reconstruction improves the morphological characterization of the thrombus.</p>" ] ] 1 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 750 "Ancho" => 526 "Tamanyo" => 67804 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Mid-esophageal right ventricular inflow-outflow view before (A, with right ventricular dilatation and severe tricuspid regurgitation) and after percutaneous thrombectomy (B, with normal size right ventricle and resolution of tricuspid regurgitation).</p>" ] ] 2 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 750 "Ancho" => 763 "Tamanyo" => 137398 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pre- (A) and post-intervention (B) angiography of the right pulmonary artery. Abundant thrombotic material was retrieved (C). Chest radiograph (D) showed wedge-shaped pleural based opacities (“Hampton's hump”).</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000003400000011/v1_201511060141/S0870255115002486/v1_201511060141/en/main.assets" "Apartado" => array:4 [ "identificador" => "357" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Imagens em cardiologia" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003400000011/v1_201511060141/S0870255115002486/v1_201511060141/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115002486?idApp=UINPBA00004E" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 10 | 4 | 14 |
| 2024 Outubro | 36 | 35 | 71 |
| 2024 Setembro | 40 | 23 | 63 |
| 2024 Agosto | 48 | 20 | 68 |
| 2024 Julho | 39 | 25 | 64 |
| 2024 Junho | 41 | 18 | 59 |
| 2024 Maio | 39 | 14 | 53 |
| 2024 Abril | 33 | 25 | 58 |
| 2024 Maro | 38 | 15 | 53 |
| 2024 Fevereiro | 28 | 23 | 51 |
| 2024 Janeiro | 31 | 26 | 57 |
| 2023 Dezembro | 31 | 16 | 47 |
| 2023 Novembro | 38 | 20 | 58 |
| 2023 Outubro | 19 | 12 | 31 |
| 2023 Setembro | 23 | 18 | 41 |
| 2023 Agosto | 24 | 21 | 45 |
| 2023 Julho | 23 | 11 | 34 |
| 2023 Junho | 27 | 9 | 36 |
| 2023 Maio | 28 | 20 | 48 |
| 2023 Abril | 19 | 2 | 21 |
| 2023 Maro | 22 | 24 | 46 |
| 2023 Fevereiro | 25 | 13 | 38 |
| 2023 Janeiro | 22 | 16 | 38 |
| 2022 Dezembro | 26 | 15 | 41 |
| 2022 Novembro | 36 | 25 | 61 |
| 2022 Outubro | 32 | 22 | 54 |
| 2022 Setembro | 22 | 24 | 46 |
| 2022 Agosto | 28 | 31 | 59 |
| 2022 Julho | 34 | 37 | 71 |
| 2022 Junho | 17 | 21 | 38 |
| 2022 Maio | 27 | 24 | 51 |
| 2022 Abril | 27 | 20 | 47 |
| 2022 Maro | 27 | 41 | 68 |
| 2022 Fevereiro | 25 | 20 | 45 |
| 2022 Janeiro | 23 | 18 | 41 |
| 2021 Dezembro | 27 | 27 | 54 |
| 2021 Novembro | 33 | 31 | 64 |
| 2021 Outubro | 31 | 39 | 70 |
| 2021 Setembro | 28 | 29 | 57 |
| 2021 Agosto | 51 | 26 | 77 |
| 2021 Julho | 33 | 30 | 63 |
| 2021 Junho | 25 | 14 | 39 |
| 2021 Maio | 22 | 21 | 43 |
| 2021 Abril | 44 | 32 | 76 |
| 2021 Maro | 75 | 14 | 89 |
| 2021 Fevereiro | 80 | 21 | 101 |
| 2021 Janeiro | 37 | 19 | 56 |
| 2020 Dezembro | 12 | 4 | 16 |
| 2020 Novembro | 31 | 21 | 52 |
| 2020 Outubro | 24 | 15 | 39 |
| 2020 Setembro | 42 | 12 | 54 |
| 2020 Agosto | 19 | 11 | 30 |
| 2020 Julho | 34 | 11 | 45 |
| 2020 Junho | 30 | 17 | 47 |
| 2020 Maio | 27 | 6 | 33 |
| 2020 Abril | 23 | 11 | 34 |
| 2020 Maro | 37 | 13 | 50 |
| 2020 Fevereiro | 41 | 22 | 63 |
| 2020 Janeiro | 21 | 9 | 30 |
| 2019 Dezembro | 27 | 10 | 37 |
| 2019 Novembro | 30 | 7 | 37 |
| 2019 Outubro | 27 | 8 | 35 |
| 2019 Setembro | 20 | 5 | 25 |
| 2019 Agosto | 36 | 5 | 41 |
| 2019 Julho | 23 | 12 | 35 |
| 2019 Junho | 27 | 11 | 38 |
| 2019 Maio | 27 | 5 | 32 |
| 2019 Abril | 18 | 16 | 34 |
| 2019 Maro | 23 | 9 | 32 |
| 2019 Fevereiro | 36 | 12 | 48 |
| 2019 Janeiro | 20 | 5 | 25 |
| 2018 Dezembro | 24 | 14 | 38 |
| 2018 Novembro | 55 | 9 | 64 |
| 2018 Outubro | 96 | 15 | 111 |
| 2018 Setembro | 34 | 9 | 43 |
| 2018 Agosto | 30 | 12 | 42 |
| 2018 Julho | 21 | 4 | 25 |
| 2018 Junho | 25 | 8 | 33 |
| 2018 Maio | 33 | 6 | 39 |
| 2018 Abril | 23 | 4 | 27 |
| 2018 Maro | 41 | 7 | 48 |
| 2018 Fevereiro | 26 | 6 | 32 |
| 2018 Janeiro | 23 | 6 | 29 |
| 2017 Dezembro | 42 | 8 | 50 |
| 2017 Novembro | 26 | 12 | 38 |
| 2017 Outubro | 18 | 8 | 26 |
| 2017 Setembro | 25 | 2 | 27 |
| 2017 Agosto | 28 | 9 | 37 |
| 2017 Julho | 21 | 5 | 26 |
| 2017 Junho | 30 | 14 | 44 |
| 2017 Maio | 32 | 14 | 46 |
| 2017 Abril | 12 | 12 | 24 |
| 2017 Maro | 17 | 3 | 20 |
| 2017 Fevereiro | 17 | 7 | 24 |
| 2017 Janeiro | 20 | 5 | 25 |
| 2016 Dezembro | 22 | 8 | 30 |
| 2016 Novembro | 6 | 11 | 17 |
| 2016 Outubro | 15 | 7 | 22 |
| 2016 Setembro | 16 | 5 | 21 |
| 2016 Agosto | 15 | 3 | 18 |
| 2016 Julho | 7 | 5 | 12 |
| 2016 Junho | 10 | 8 | 18 |
| 2016 Maio | 1 | 7 | 8 |
| 2016 Abril | 20 | 2 | 22 |
| 2016 Maro | 28 | 6 | 34 |
| 2016 Fevereiro | 34 | 18 | 52 |
| 2016 Janeiro | 26 | 15 | 41 |
| 2015 Dezembro | 122 | 75 | 197 |
| 2015 Novembro | 125 | 81 | 206 |
Mostrar tudo
