You searched for:"Arnaldo Prata"
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Original Article
Knowledge regarding extracorporeal membrane oxygenation management among Brazilian pediatric intensivists: a cross-sectional survey
Crit Care Sci. 2023;35(1):57-65
Abstract
Original ArticleKnowledge regarding extracorporeal membrane oxygenation management among Brazilian pediatric intensivists: a cross-sectional survey
Crit Care Sci. 2023;35(1):57-65
DOI 10.5935/2965-2774.20230350-pt
Views4ABSTRACT
Objective:
To assess Brazilian pediatric intensivists’ general knowledge of extracorporeal membrane oxygenation, including evidence for its use, the national funding model, indications, and complications.
Methods:
This was a multicenter cross-sectional survey including 45 Brazilian pediatric intensive care units. A convenience sample of 654 intensivists was surveyed regarding their knowledge on managing patients on extracorporeal membrane oxygenation, its indications, complications, funding, and literature evidence.
Results:
The survey addressed questions regarding the knowledge and experience of pediatric intensivists with extracorporeal membrane oxygenation, including two clinical cases and 6 optional questions about the management of patients on extracorporeal membrane oxygenation. Of the 45 invited centers, 42 (91%) participated in the study, and 412 of 654 (63%) pediatric intensivists responded to the survey. Most pediatric intensive care units were from the Southeast region of Brazil (59.5%), and private/for-profit hospitals represented 28.6% of the participating centers. The average age of respondents was 41.4 (standard deviation 9.1) years, and the majority (77%) were women. Only 12.4% of respondents had taken an extracorporeal membrane oxygenation course. Only 19% of surveyed hospitals have an extracorporeal membrane oxygenation program, and only 27% of intensivists reported having already managed patients on extracorporeal membrane oxygenation. Specific extracorporeal membrane oxygenation management questions were responded to by only 64 physicians (15.5%), who had a fair/good correct response rate (median 63.4%; range 32.8% to 91.9%).
Conclusion:
Most Brazilian pediatric intensivists demonstrated limited knowledge regarding extracorporeal membrane oxygenation, including its indications and complications. Extracorporeal membrane oxygenation is not yet widely available in Brazil, with few intensivists prepared to manage patients on extracorporeal membrane oxygenation and even fewer intensivists recognizing when to refer patients to extracorporeal membrane oxygenation centers.
Keywords:ChildExtracorporeal membrane oxygenationHealth knowledge, attitudes, practicePediatric intensive care unitsSurvey and questionnairesSee more -
Commentary
Pediatric delirium in times of COVID-19
Rev Bras Ter Intensiva. 2021;33(4):483-486
Abstract
CommentaryPediatric delirium in times of COVID-19
Rev Bras Ter Intensiva. 2021;33(4):483-486
DOI 10.5935/0103-507X.20210070
Views0IntroductionDelirium is defined as a neurocognitive syndrome characterized by the acute onset of brain dysfunction with fluctuations in the basal mental state, inattention and disorganized thinking or altered levels of consciousness.(,) It is a frequent complication in intensive care units (ICUs).() Its occurrence is strongly predictive of an increase in the duration of mechanical ventilation […]See more -
Original Article
Cross-cultural adaptation of the Richmond Agitation-Sedation Scale to Brazilian Portuguese for the evaluation of sedation in pediatric intensive care
Rev Bras Ter Intensiva. 2021;33(1):102-110
Abstract
Original ArticleCross-cultural adaptation of the Richmond Agitation-Sedation Scale to Brazilian Portuguese for the evaluation of sedation in pediatric intensive care
Rev Bras Ter Intensiva. 2021;33(1):102-110
DOI 10.5935/0103-507X.20210011
Views0ABSTRACT
Objective:
To perform a cross-cultural adaptation of the Richmond Agitation-Sedation Scale (RASS) to Brazilian Portuguese for the evaluation of sedation in pediatric intensive care.
Methods:
Cross-cultural adaptation process including the conceptual, item, semantic and operational equivalence stages according to current recommendations.
Results:
Pretests, divided into two stages, included 30 professionals from the pediatric intensive care unit of a university hospital, who administered the translated RASS to patients aged 29 days to 18 years. The pretests showed a content validity index above 0.90 for all items: 0.97 in the first stage of pretests and 0.99 in the second.
Conclusion:
The cross-cultural adaptation of RASS to Brazilian Portuguese resulted in a version with excellent comprehensibility and acceptability in a pediatric intensive care setting. Reliability and validity studies should be performed to evaluate the psychometric properties of the Brazilian Portuguese version of the RASS.
Keywords:Conscious sedationCross-cultural comparisonDeep sedationIntensive care units, pediatricTranslatingSee more -
Original Articles
Translation and cross-cultural adaptation of the Pediatric Confusion Assessment Method for the Intensive Care Unit into Brazilian Portuguese for the detection of delirium in pediatric intensive care units
Rev Bras Ter Intensiva. 2018;30(1):71-79
Abstract
Original ArticlesTranslation and cross-cultural adaptation of the Pediatric Confusion Assessment Method for the Intensive Care Unit into Brazilian Portuguese for the detection of delirium in pediatric intensive care units
Rev Bras Ter Intensiva. 2018;30(1):71-79
DOI 10.5935/0103-507X.20180013
Views0ABSTRACT
Objective:
To undertake the translation and cross-cultural adaption into Brazilian Portuguese of the Pediatric Confusion Assessment Method for the Intensive Care Unit for the detection of delirium in pediatric intensive care units, including the algorithm and instructions.
Methods:
A universalist approach for the translation and cross-cultural adaptation of health measurement instruments was used. A group of pediatric critical care specialists assessed conceptual and item equivalences. Semantic equivalence was evaluated by means of a translation from English to Portuguese by two independent translators; reconciliation into a single version; back-translation by a native English speaker; and consensus among six experts with respect to language and content understanding by means of Likert scale responses and the Content Validity Index. Finally, operational equivalence was assessed by applying a pre-test to 30 patients.
Results:
The back-translation was approved by the original authors. The medians of the expert consensus responses varied between good and excellent, except for the feature “acute onset” of the instructions. Items with a low Content Validity Index for the features “acute onset” and “disorganized thinking” were adapted. In the pre-test, the expression “signal with your head” was modified into “nod your head” for better understanding. No further adjustments were necessary, resulting in the final version for Brazilian Portuguese.
Conclusion:
The Brazilian version of the Pediatric Confusion Assessment Method for the Intensive Care Unit was generated in agreement with the international recommendations and can be used in Brazil for the diagnosis of delirium in critically ill children 5 years of age or above and with no developmental cognitive disabilities.
Keywords:Confusion/diagnosisDelirium/diagnosisIntensive care units, pediatricpCAM-ICUSurveys and Questionnaires/standardsTranslationSee more -
Review Articles
Use of biomarkers in pediatric sepsis: literature review
Rev Bras Ter Intensiva. 2016;28(4):472-482
Abstract
Review ArticlesUse of biomarkers in pediatric sepsis: literature review
Rev Bras Ter Intensiva. 2016;28(4):472-482
DOI 10.5935/0103-507X.20160080
Views0See moreABSTRACT
Despite advances in recent years, sepsis is still a leading cause of hospitalization and mortality in infants and children. The presence of biomarkers during the response to an infectious insult makes it possible to use such biomarkers in screening, diagnosis, prognosis (risk stratification), monitoring of therapeutic response, and rational use of antibiotics (for example, the determination of adequate treatment length). Studies of biomarkers in sepsis in children are still relatively scarce. This review addresses the use of biomarkers in sepsis in pediatric patients with emphasis on C-reactive protein, procalcitonin, interleukins 6, 8, and 18, human neutrophil gelatinase, and proadrenomedullin. Assessment of these biomarkers may be useful in the management of pediatric sepsis.
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Original Articles – Clinical Research
Professional profile of pediatric intensivists in Rio de Janeiro, southeastern Brazil
Rev Bras Ter Intensiva. 2011;23(4):462-469
Abstract
Original Articles – Clinical ResearchProfessional profile of pediatric intensivists in Rio de Janeiro, southeastern Brazil
Rev Bras Ter Intensiva. 2011;23(4):462-469
DOI 10.1590/S0103-507X2011000400011
Views0OBJECTIVE: This study described the sociodemographic profile and professional qualifications of pediatric intensive care physicians in the State of Rio de Janeiro (RJ), southeastern Brazil. METHODS: This investigation was an observational, cross-sectional and descriptive study that was conducted in neonatal, pediatric and mixed intensive care units in the State of Rio de Janeiro. Physicians working in the participating intensive care units voluntarily completed a semistructured and anonymous questionnaire. Questionnaires that were not returned within 30 days were considered lost, and questionnaires with less than 75% questions completed were excluded. The differences in neonatal and pediatric intensive care physicians’ medical training were compared using the Chi-squared test with a 5% significance level. RESULTS: A total of 410 physicians were included in this study: 84% female, 48% between 30 and 39 years old and 45% with monthly incomes between US $1,700 to 2,700. Forty percent of these physicians worked exclusively in this specialty, and 72% worked in more than one intensive care unit. Only 50% of the participants had received specific training (either medical residency or specialization) in neonatology, and only 33% were board-certified specialists in this area. Only 27% of the physicians had received specific training in pediatric intensive care medicine, and only 17% were board-certified specialists (p < 0.0005 for both comparisons). Most (87%) physicians had participated in scientific events within the past 5 years, and 55% used the internet for continued medical education. However, only 25% had participated in any research. Most (63%) physicians were dissatisfied with their professional activity; 49% were dissatisfied due to working conditions, 23% due to low incomes and 18% due to training-related issues. CONCLUSION: These results suggested that the medical qualifications of neonatal and pediatric intensive care physicians in the State of Rio de Janeiro, Brazil are inadequate, especially in pediatric intensive care medicine. A high level of dissatisfaction was reported, which may jeopardize the quality of medical assistance that is provided by these professionals.
Keywords:BrazilEducation, medicalIntensive careIntensive care units, neonatalIntensive care units, pediatricProfessional practiceSee more -
Guidelines for the management of patients with severe forms of dengue
Rev Bras Ter Intensiva. 2011;23(2):125-133
Abstract
Guidelines for the management of patients with severe forms of dengue
Rev Bras Ter Intensiva. 2011;23(2):125-133
DOI 10.1590/S0103-507X2011000200004
Views0See moreDengue is the most common vector-borne viral infection worldwide. In Brazil, the incidence has increased with successive epidemics, and an increasing proportion of patients present with severe forms of the disease. The prognosis for these patients is directly influenced by the quality of medical care. These guidelines present the management of the severe forms of dengue, including the recognition of warning signs, the treatment for prompt re-establishment of euvolemia and the evaluation and appropriate care of potential complications, thus reducing morbidity and mortality of infected children and adults
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KEY WORDS
Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis