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You searched for:"Helena Almeida"

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  • Case Reports

    Rhabdomyolysis as a manifestation of a metabolic disease: a case report

    Revista Brasileira de Terapia Intensiva. 2017;29(1):111-114
    01-01-2017

    Abstract

    Case Reports

    Rhabdomyolysis as a manifestation of a metabolic disease: a case report

    Revista Brasileira de Terapia Intensiva. 2017;29(1):111-114
    01-01-2017

    DOI 10.5935/0103-507X.20170016

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    ABSTRACT

    Rhabdomyolysis is a process of muscle destruction that can present with varying clinical manifestations. In pediatric patients, its main etiology is infectious diseases. We present a previously healthy adolescent who was admitted to our emergency department with a four-day history of myalgia, muscle weakness and dark urine. At presentation, she was dehydrated. Blood analysis revealed acute renal failure and increased muscular enzymes.

    She was transferred to our pediatric intensive care unit. Medical therapies for correction of dehydration and the ionic and metabolic consequences of renal failure were performed. Due to oliguria, renal replacement therapy was initiated. An etiological investigation revealed a beta-oxidation defect. Metabolic diseases are a known cause of rhabdomyolysis. Muscular destruction should be diagnosed early in order to avoid its potential consequences. Generally, the treatment of rhabdomyolysis is conservative, although in some situations, a more invasive approach is needed.

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  • Original Articles - Clinical Research

    Noninvasive ventilation in acute respiratory failure from respiratory syncytial virus bronchiolitis

    Revista Brasileira de Terapia Intensiva. 2012;24(4):375-380
    01-30-2012

    Abstract

    Original Articles - Clinical Research

    Noninvasive ventilation in acute respiratory failure from respiratory syncytial virus bronchiolitis

    Revista Brasileira de Terapia Intensiva. 2012;24(4):375-380
    01-30-2012

    DOI 10.1590/S0103-507X2012000400014

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    OBJECTIVES: The present study focused on respiratory syncytial virus bronchiolitis with respiratory failure. The aim of the study was to determine whether noninvasive ventilation reduces the need for endotracheal intubation or slows the clinical progression of acute respiratory syncytial virus bronchiolitis by reducing the incidence of infectious complications. METHODS: The present study was a retrospective cohort study. Cohort A was comprised of children who were admitted to the pediatric intensive and special care unit from 2003-2005 before starting noninvasive ventilation; cohort B was comprised of children who were admitted to the pediatric intensive and special care unit from 2006-2008 after starting noninvasive ventilation. With the exception of noninvasive ventilation, the therapeutic support was the same for the two groups. All children who were diagnosed with respiratory syncytial virus bronchiolitis and respiratory failure between November 2003 and March 2008 were included in the cohort. Demographic, clinical and blood gas variables were analyzed. RESULTS: A total of 162 children were included; 75% of the subjects were less than 3 months old. Group A included 64 children, and group B included 98 children. In group B, 34 of the children required noninvasive ventilation. The distributions of the variables age, preterm birth, congenital heart disease, cerebral palsy and chronic lung disease were similar between the two groups. On admission, the data for blood gas analysis and the number of apneas were not significantly different between the groups. In group B, fewer children required invasive ventilation (group A: 12/64 versus group B: 7/98; p=0.02), and there was a reduction in the number of cases of bacterial pneumonia (group A: 19/64 versus group B: 12/98; p=0.008). There was no record of mortality in either of the groups. CONCLUSION: By comparing children with the same disease both before and after noninvasive ventilation was used for ventilation support, we verified a reduction in infectious complications and cases requiring intubation.

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    Noninvasive ventilation in acute respiratory failure from respiratory syncytial virus bronchiolitis

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