Publications by authors named "Claudio F de Oliveira"
Article Synopsis
- Septic shock significantly affects children globally, leading to high hospitalisation and mortality rates, prompting the paediatric Surviving Sepsis Campaign to update guidelines in 2020 based on existing evidence.
- Recent trials from low and middle-income countries (LMICs) have provided new insights into effective treatment options, such as fluid management and vasoactive infusions.
- This viewpoint highlights the need for improved sepsis care in LMICs by addressing early recognition of septic shock, fluid resuscitation, and individualised treatment approaches using accessible monitoring tools.
Sepsis, defined as infection with associated organ dysfunction, accounts for most childhood deaths due to infection globally. Evidence for the optimal support of children with septic shock refractory to the initial sepsis management bundle remains minimal. There is an urgent need for more effective interventions.
View Article and Find Full Text PDFThe epidemiology of sepsis in paediatric intensive care units in Brazil (the Sepsis PREvalence Assessment Database in Pediatric population, SPREAD PED): an observational study.
Lancet Child Adolesc Health
December 2021
Background: Data on the prevalence and mortality of paediatric sepsis in resource-poor settings are scarce. We aimed to assess the prevalence and in-hospital mortality of severe sepsis and septic shock treated in paediatric intensive care units (PICUs) in Brazil, and risk factors for mortality.
Methods: We performed a nationwide, 1-day, prospective point prevalence study with follow-up of patients with severe sepsis and septic shock, using a stratified random sample of all PICUs in Brazil.
Article Synopsis
- The objective was to create evidence-based guidelines for clinicians treating children with septic shock and related organ dysfunction.
- A diverse panel of 49 international experts was assembled, including specialists from various organizations, to collaboratively review and discuss the management of septic conditions in children.
- The panel produced 77 management statements, categorizing them as six strong recommendations, 52 weak ones, and nine best practice suggestions based on existing, though inconclusive, evidence.
Article Synopsis
- The objective of the study was to create evidence-based recommendations for clinicians treating children with septic shock and related organ dysfunction, involving a global panel of 49 experts.
- The guideline development process included thorough discussions via teleconferences and dedicated meetings, ensuring that a conflict-of-interest policy was strictly followed throughout.
- As a result, 77 management statements were developed, with six classified as strong recommendations and the majority as weak, highlighting the complexity and variability in clinical practice for these conditions.
Article Synopsis
- About 29,000 children under 5 die every day globally, with sepsis being the leading cause of death in this age group, unlike adults who primarily face mortality due to vasomotor paralysis.
- The article reviews the effectiveness and challenges of implementing pediatric sepsis treatment guidelines from the American College of Critical Care Medicine, noting a lack of strong evidence supporting all their recommendations.
- Early goal-directed therapy has been identified as a beneficial intervention in treating pediatric septic shock, but there's more work needed to simplify and increase the use of these treatment methods.
Introduction: The ACCM/PALS guidelines address early correction of paediatric septic shock using conventional measures. In the evolution of these recommendations, indirect measures of the balance between systemic oxygen delivery and demands using central venous or superior vena cava oxygen saturation (ScvO(2) > or = 70%) in a goal-directed approach have been added. However, while these additional goal-directed endpoints are based on evidence-based adult studies, the extrapolation to the paediatric patient remains unvalidated.
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