You searched for:"Jader Pereira Almeida"
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Original Article
Impact of the use of nephrotoxic drugs in critically ill pediatric patients
Rev Bras Ter Intensiva. 2020;32(4):557-563
Abstract
Original ArticleImpact of the use of nephrotoxic drugs in critically ill pediatric patients
Rev Bras Ter Intensiva. 2020;32(4):557-563
DOI 10.5935/0103-507X.20200093
Views0Abstract
Objective:
To evaluate the association between the use of nephrotoxic drugs and acute kidney injury in critically ill pediatric patients.
Methods:
This was a retrospective cohort study involving all children admitted to the intensive care unit of a pediatric hospital during a 1-year period. Acute kidney injury was defined according to the KDIGO classification. Patients with a length of hospital stay longer than 48 hours and an age between 1 month and 14 years were included. Patients with acute or chronic nephropathy, uropathy, congenital or acquired heart disease, chronic use of nephrotoxic drugs, rhabdomyolysis and tumor lysis syndrome were excluded. Patients were classified according to the use of nephrotoxic drugs during their stay at the pediatric intensive care unit.
Results:
The sample consisted of 226 children, of whom 37.1% used nephrotoxic drugs, 42.4% developed acute kidney injury, and 7.5% died. The following drugs, when used alone, were associated with acute kidney injury: acyclovir (p < 0.001), vancomycin (p < 0.001), furosemide (p < 0.001) and ganciclovir (p = 0.008). The concomitant use of two or more nephrotoxic drugs was characterized as an independent marker of renal dysfunction (p < 0.001). After discharge from the pediatric intensive care unit, renal function monitoring in the ward was inadequate in 19.8% of cases.
Conclusion:
It is necessary for intensivist physicians to have knowledge of the main nephrotoxic drugs to predict, reduce or avoid damage to their patients.
Keywords:Acute kidney injuryChildDrug-related side effects and adverse reactionsIntensive care units, pediatricToxicitySee moreViews0
Abstract
Original ArticleImpact of the use of nephrotoxic drugs in critically ill pediatric patients
Rev Bras Ter Intensiva. 2020;32(4):557-563
DOI 10.5935/0103-507X.20200093
Views0Abstract
Objective:
To evaluate the association between the use of nephrotoxic drugs and acute kidney injury in critically ill pediatric patients.
Methods:
This was a retrospective cohort study involving all children admitted to the intensive care unit of a pediatric hospital during a 1-year period. Acute kidney injury was defined according to the KDIGO classification. Patients with a length of hospital stay longer than 48 hours and an age between 1 month and 14 years were included. Patients with acute or chronic nephropathy, uropathy, congenital or acquired heart disease, chronic use of nephrotoxic drugs, rhabdomyolysis and tumor lysis syndrome were excluded. Patients were classified according to the use of nephrotoxic drugs during their stay at the pediatric intensive care unit.
Results:
The sample consisted of 226 children, of whom 37.1% used nephrotoxic drugs, 42.4% developed acute kidney injury, and 7.5% died. The following drugs, when used alone, were associated with acute kidney injury: acyclovir (p < 0.001), vancomycin (p < 0.001), furosemide (p < 0.001) and ganciclovir (p = 0.008). The concomitant use of two or more nephrotoxic drugs was characterized as an independent marker of renal dysfunction (p < 0.001). After discharge from the pediatric intensive care unit, renal function monitoring in the ward was inadequate in 19.8% of cases.
Conclusion:
It is necessary for intensivist physicians to have knowledge of the main nephrotoxic drugs to predict, reduce or avoid damage to their patients.
Keywords:Acute kidney injuryChildDrug-related side effects and adverse reactionsIntensive care units, pediatricToxicitySee more -
Original Article
Association between pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score and mortality in a pediatric intensive care unit: a retrospective study
Rev Bras Ter Intensiva. 2018;30(4):429-435
Abstract
Original ArticleAssociation between pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score and mortality in a pediatric intensive care unit: a retrospective study
Rev Bras Ter Intensiva. 2018;30(4):429-435
DOI 10.5935/0103-507X.20180065
Views0See moreABSTRACT
Objective:
To evaluate the association between acute kidney injury through the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score and mortality in a pediatric intensive care unit.
Methods:
This retrospective cohort study assessed all children admitted to the pediatric intensive care unit of a reference hospital in Brazil from January to December 2016. Patients were screened for the presence of acute kidney injury through the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score. Patients were subdivided into the stages of Risk, Injury and Kidney Failure.
Results:
The sample comprised 192 children, of whom 45.8% developed acute kidney injury, with 79.5% of the cases identified up to 72 hours after admission. Patients with acute kidney injury showed a 3.74 increase risk of death (p = 0.01) than the control group. Patients with kidney failure had a mortality rate that was 8.56 times greater than that of the remaining sample (p < 0.001). The variables that were associated with the stages of acute kidney injury were nephrotoxic drugs (p = 0.025), renal replacement therapy (p < 0.001), vasoactive drugs (p < 0.001), pediatric risk of mortality 2 score (p = 0.023), fluid overload (p = 0.005), pediatric intensive care unit length of stay (p = 0.001) and death (p < 0.001).
Conclusion:
In this study, the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score proved to be a useful tool for the early identification of severely ill children with acute kidney injury, showing an association with mortality. We thus suggest its use for pediatric intensive care unit patient admission.
Views0Abstract
Original ArticleAssociation between pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score and mortality in a pediatric intensive care unit: a retrospective study
Rev Bras Ter Intensiva. 2018;30(4):429-435
DOI 10.5935/0103-507X.20180065
Views0See moreABSTRACT
Objective:
To evaluate the association between acute kidney injury through the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score and mortality in a pediatric intensive care unit.
Methods:
This retrospective cohort study assessed all children admitted to the pediatric intensive care unit of a reference hospital in Brazil from January to December 2016. Patients were screened for the presence of acute kidney injury through the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score. Patients were subdivided into the stages of Risk, Injury and Kidney Failure.
Results:
The sample comprised 192 children, of whom 45.8% developed acute kidney injury, with 79.5% of the cases identified up to 72 hours after admission. Patients with acute kidney injury showed a 3.74 increase risk of death (p = 0.01) than the control group. Patients with kidney failure had a mortality rate that was 8.56 times greater than that of the remaining sample (p < 0.001). The variables that were associated with the stages of acute kidney injury were nephrotoxic drugs (p = 0.025), renal replacement therapy (p < 0.001), vasoactive drugs (p < 0.001), pediatric risk of mortality 2 score (p = 0.023), fluid overload (p = 0.005), pediatric intensive care unit length of stay (p = 0.001) and death (p < 0.001).
Conclusion:
In this study, the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score proved to be a useful tool for the early identification of severely ill children with acute kidney injury, showing an association with mortality. We thus suggest its use for pediatric intensive care unit patient admission.
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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