Publications by authors named "Pedro C R Garcia"
Article Synopsis
- The study aimed to evaluate the effectiveness of the Net Promoter Score (NPS) in measuring parental satisfaction in pediatric intensive care units (PICUs) in Brazil.
- The research involved interviewing 78 parents or guardians of PICU patients and comparing NPS results with the established EMPATHIC-30 tool, finding that NPS was highly sensitive but lacked specificity in identifying dissatisfied respondents.
- While the NPS showed 100% sensitivity at most cutoff points, its ability to accurately pinpoint unhappy users was significantly limited, indicating a need for complementary assessment methods.
Impact of the COVID-19 Pandemic on Patient- and Family-Centered Care and on the Mental Health of Health Care Workers, Patients, and Families.
Front Pediatr
July 2022
During the COVID-19 pandemic, hospitals around the world were forced to reorganize their processes in an attempt to contain the spread of the virus while still providing adequate care to patients. In the Pediatric Intensive Care Unit (PICU) setting, changes in family visitation protocols and restrictions on parent chaperones during hospitalization, as well as other changes, interfered with care. Based on a narrative review of the literature, supported by the authors' observations in practice, we aimed to describe the impact of the pandemic on patient and family-centered care (PFCC) in the PICU environment, especially regarding the presence of family members, family support, and communication with patients and their families, as well as the effects of changes in these practices on the mental health of those involved.
View Article and Find Full Text PDFObjectives: To describe pulmonary resistance in children undergoing invasive mechanical ventilation (MV) for different causes.
Design: A cross-sectional study.
Setting: Two PICUs in the South region of Brazil.
Objective: To verify the parents' satisfaction in relation to the care provided to their child admitted to the pediatric intensive care unit and associated clinical factors.
Method: Exploratory, cross-sectional study, with a total of 84 parents, in a private hospital in Sao Paulo, Brazil. Data collection took place from March 2019 to January 2020, in the post-discharge period.
Objective: The proportion of children with complex chronic conditions is increasing in PICUs around the world. We determined the prevalence and functional status of children with complex chronic conditions in Brazilian PICUs during the COVID-19 pandemic.
Methods: The authors conducted a point prevalence cross-sectional study among fifteen Brazilian PICUs during the COVID-19 pandemic.
Objective: To compare the nursing workload using the Nursing Activities Score (NAS), Therapeutic Intervention Scoring System-28 (TISS-28) and Nine Equivalents of Nursing Manpower Use Score (NEMS) instruments in children admitted to a Pediatric Intensive Care Unit in a university hospital.
Method: A prospective cohort study performed in a Pediatric Intensive Care Unit, with a sample formed of all children hospitalized during the study period. Nursing workload was evaluated using the TISS-28, NEMS and NAS instruments, and further divided into two groups: Group 1 forming a category of basic activities items and Group 2 forming a category of other support and intervention activities.
Article Synopsis
- The study aimed to evaluate the prevalence of life support limitation (LSL) among pediatric patients who died after a stay in a pediatric intensive care unit (PICU) for at least 24 hours, along with the involvement of parents in the decision-making process.
- A retrospective analysis included 53 patients; findings revealed that 45.3% had LSL documented, with most of those who did have a do-not-resuscitate order, and half had life support withdrawn.
- The results indicated that LSLs were more common in older and more critically ill patients, with significant parental participation and a noted increase in both LSL prevalence and life support withdrawal compared to earlier cohorts.
Brazilian Translation, Cross-Cultural Adaptation, Validity, and Reliability of the EMpowerment of PArents in THe Intensive Care 30 (EMPATHIC-30) Questionnaire to Measure Parental Satisfaction in PICUs.
Pediatr Crit Care Med
June 2021
Article Synopsis
- The study aimed to translate, adapt culturally, validate, and test the reliability of the EMPATHIC-30 questionnaire for Brazilian parents of children discharged from the PICU.
- The translation followed best practices, resulting in a total content validity coefficient above the accepted average, indicating strong content relevance.
- Reliability testing showed varying results across different domains, with the overall internal consistency being excellent at 0.90, confirming the instrument's reliability for future use in assessing parental empowerment in intensive care settings.
Objective: To evaluate the prognostic performance of the Pediatric Index of Mortality 2 (PIM2), ferritin, lactate, C-reactive protein (CRP), and leukocytes, alone and in combination, in pediatric patients with sepsis admitted to the pediatric intensive care unit (PICU).
Methods: A retrospective study was conducted in a PICU in Brazil. All patients aged 6 months to 18 years admitted with a diagnosis of sepsis were eligible for inclusion.
Background: Because of its high prevalence and negative impact on quality of life and longevity, overweight in childhood and adolescence is a major public health concern. The objective of the present study was to determine whether excess weight is associated with clinical outcomes in critically ill children and adolescents admitted to the pediatric intensive care unit (PICU).
Method: This retrospective cohort study was performed with children and adolescents admitted to a PICU over 3 years.
Article Synopsis
- - This study aimed to assess serum ferritin levels measured within 48 hours of hospital admission as a predictor of mortality in pediatric sepsis patients, highlighting a significant link between ferritin levels and adverse outcomes.
- - Conducted at a tertiary care hospital in South America, it included 350 children aged 6 months to 18 years diagnosed with sepsis, identifying a 40.3% prevalence of iron deficiency anemia among them.
- - Findings revealed that higher serum ferritin levels correlated with increased mortality rates, with a notable 10-fold increase in ferritin associated with five times the risk of mortality, indicating that ferritin can be a valuable prognostic marker in this setting.
Article Synopsis
- The study aimed to assess whether measuring cerebrospinal fluid (CSF) ferritin levels can help diagnose purulent meningitis (PM) in children.
- Researchers analyzed 81 children suspected of having meningitis, measuring CSF ferritin levels and comparing results across three diagnostic groups: PM, aseptic meningitis (AM), and no meningitis.
- Findings showed significantly higher CSF ferritin levels in children with PM compared to those with AM or no meningitis, suggesting that CSF ferritin could serve as a valuable biomarker for diagnosing PM in affected children.
Objective: Review the main aspects of the definition, diagnosis, and management of pediatric patients with sepsis and septic shock.
Source Of Data: A search was carried out in the MEDLINE and Embase databases. The articles were chosen according to the authors' interest, prioritizing those published in the last five years.
Objective: To verify the association between prone position, increased diuresis, and decreased cumulative fluid balance in critically ill pediatric patients who underwent mechanical ventilation (MV) for pulmonary causes and describe adverse events related to the use of the position.
Methods: This is a retrospective observational study. Patients aged between 1 month and 12 years who underwent MV for pulmonary causes, between January 2013 and December 2015, were selected and divided between those who were put on prone position (PG) and those who were not (CG) during the hospitalization at the Pediatric Intensive Care Unit (PICU).
Prevalence, mortality and risk factors associated with very low birth weight preterm infants: an analysis of 33 years.
J Pediatr (Rio J)
October 2020
Objective: To assess the prevalence, mortality and risk factors associated with the birth of very low birth weight preterm infants over a period of 33 years.
Methods: Four cross-sectional studies were analyzed, using data from perinatal interviews of birth cohorts in the city of Pelotas collected in 1982, 1993, 2004, and 2015. Based on perinatal questionnaires, anthropometric measurements of newborns and death certificates were analyzed to obtain the prevalence rate, neonatal mortality, and risk factors (maternal age, income and type of delivery) for very low birth weight.
Objective: To compare the prevalence of malnutrition during two time periods in a pediatric intensive care unit.
Methods: This was a retrospective cross-sectional study of patients admitted to the pediatric intensive care unit of a university hospital during two one-year periods with an interval of four years between them. Nutritional evaluation was conducted based on weight and height measured at admission.
Objective: The stable microbubble test on gastric aspirate and on amniotic fluid has been used for the diagnosis of respiratory distress syndrome in the newborn. However, no study has performed this test on oral aspirates from premature infants. The objective of this study was to evaluate the performance of the stable microbubble test on oral aspirates from preterm newborns to predict respiratory distress syndrome.
View Article and Find Full Text PDFTranslation 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
March 2018
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.
Objective: To estimate the workload and size the nursing team using the scales TISS-28 and NEMS in a pediatric intensive care unit.
Methods: An observational prospective study with a quantitative approach was conducted at the pediatric intensive care unit of a university hospital from Jan 1st, 2009 to Dec 31st, 2009. All children who remained hospitalized for more than 8 hours were included, with length of stay of 4 hours in case of death.
Objective: The aim of this study was to present a review on the evolution, development, and consolidation of the pediatric emergency abroad and in Brazil, as well as to discuss the residency program in this key area for pediatricians.
Data Sources: This was a narrative review, in which the authors used pre-selected documents utilized as the minimum requirements for the Residency Program in Pediatric Emergency Medicine and articles selected by interest for the theme development, at the SciELO and Medline databases, between 2000 and 2017.
Data Synthesis: The historical antecedents and the initial evolution of pediatric emergency in Brazil, as well as several challenges were described, regarding the organization, the size, the training of professionals, and also the regulation of the professional practice in this new specialty.
Article Synopsis
- The study aimed to explore how echocardiogram results, ferritin levels, C-reactive protein, and leukocyte counts relate to poor outcomes in pediatric sepsis patients.
- A prospective cohort study included children aged 28 days to 18 years who had sepsis and required prolonged mechanical ventilation and vasoactive drugs; key indicators were measured over 72 hours.
- Results showed that higher ferritin levels and signs of cardiac dysfunction were linked to longer hospital stays, more extended mechanical ventilation, and a higher inotropic agent usage, indicating worse health outcomes for the patients.