Publications by authors named "Pedro Povoa"

Article Synopsis
  • The D-PRISM study investigated global practices for diagnosing and treating pneumonia in ICU settings, focusing on community-acquired, hospital-acquired, and ventilator-associated pneumonia across different countries.
  • A survey gathered responses from 1,296 ICU clinicians across 72 countries, revealing varied diagnostic processes and a lack of standardized microbiological testing, particularly in lower-income regions.
  • Findings indicated that the typical antibiotic treatment duration was 5-7 days, with shorter durations linked to effective antimicrobial stewardship programs in higher-income countries.
View Article and Find Full Text PDF

: The influence of comorbidity on long-term hospitalization and mortality after COVID-19 in adults (40-59 years) and older adults (≥60 years) is yet to be explored. : This is a Danish population-based cohort study of patients with a first-time positive PCR test for COVID-19 from 1 March 2020, to 28 February 2022 (N = 1,034,103). Exposed cohorts were patients with 1) a Charlson Comorbidity Index (CCI) score of 1-2 and 2) a CCI score ≥3, who were compared to patients without comorbidity (CCI of zero) within the groups of adults (67.

View Article and Find Full Text PDF

Acute respiratory distress syndrome (ARDS) can be associated with a wide multiplicity of causes, including diffuse alveolar haemorrhage (DAH). Vasculitis associated with anti-neutrophil cytoplasmic antibody (ANCA), particularly granulomatosis with polyangiitis (GPA), is one of the most common causes of DAH, primarily affecting small and medium-sized vessels in the lungs and kidneys. Diagnosing GPA can be challenging, and it should be considered a potential cause of DAH, even in the absence of other organ involvement.

View Article and Find Full Text PDF

Background: Critically ill patients are at high risk of Intensive Care Unit (ICU) Acquired weakness, which negatively impacts clinical outcomes. Traditional muscle mass and nutritional status assessments are often impractical in the ICU. Ultrasound offers a promising, non-invasive alternative.

View Article and Find Full Text PDF

Introduction: Acute liver failure (ALF) is a rare disease with high mortality. Acute kidney injury (AKI) following ALF is frequent. We assessed AKI impact on long-term kidney function among ALF survivors.

View Article and Find Full Text PDF
Article Synopsis
  • This study looked at how low levels of a type of white blood cell (called lymphocytes) in COVID-19 patients can affect their health outcomes.
  • It included 912 adult patients in intensive care units in Portugal and Brazil to see how many had low lymphocyte counts and how it impacted their condition.
  • The findings showed that patients with low lymphocyte counts were much sicker, needed more medical help, and had a higher chance of dying from the illness compared to those with normal levels.
View Article and Find Full Text PDF
Article Synopsis
  • * Dysregulation of these systems can lead to problems like coagulopathy (abnormal blood clotting), endothelial dysfunction (issues with blood vessel linings), and multi-organ failure.
  • * The review focuses on the underlying mechanisms of these dysfunctions, their clinical importance, how to evaluate them, and potential treatments aimed at improving patient outcomes in sepsis.
View Article and Find Full Text PDF
Article Synopsis
  • Many cancer patients and people with weakened immune systems face a higher risk of serious infections because their bodies can't fight germs as well.
  • Factors like age, other health problems, and the type and stage of cancer can make them even more vulnerable to severe conditions like septic shock.
  • To improve survival rates, it's important to quickly identify infections and provide specialized care, using new technologies and teamwork among healthcare providers.
View Article and Find Full Text PDF

Purpose Of Review: The development and use of immunomodulators and other therapies during the coronavirus disease 2019 (COVID-19) pandemic provided several lessons with respect to these therapies, and to how medical researchers and clinicians should approach the next pandemic.

Recent Findings: New or repurposed therapies, particularly immunomodulator treatments, for the treatment of an infectious disease will always be associated with inherent patient risk and this was the case during the COVID-19 pandemic. The concomitant development and use of effective antimicrobial therapies along with close monitoring for secondary infections is paramount for patient safety and treatment success.

View Article and Find Full Text PDF

Severe acute respiratory infections, such as community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia, constitute frequent and lethal pulmonary infections in the intensive care unit (ICU). Despite optimal management with early appropriate empiric antimicrobial therapy and adequate supportive care, mortality remains high, in part attributable to the aging, growing number of comorbidities, and rising rates of multidrug resistance pathogens. Biomarkers have the potential to offer additional information that may further improve the management and outcome of pulmonary infections.

View Article and Find Full Text PDF
Article Synopsis
  • Platelet transfusions are commonly administered in ICUs for patients with low platelet counts (thrombocytopenia), but the specific practices and their outcomes are not well-documented.
  • In a study of 504 ICU patients across Europe and the U.S., 20.8% received platelet transfusions, primarily using pooled products, with varying practices in dosage and volume across different countries.
  • The research found that while platelet transfusions are frequent, they provide limited increases in platelet counts, indicating potential inconsistencies in their effectiveness and administration practices.
View Article and Find Full Text PDF

Burden of bacteraemia is rising due to increased average life expectancy in developed countries. This study aimed to compare the epidemiology and outcomes of bacteraemia in two similarly ageing populations with different ethnicities in Singapore and Denmark. Historical cohorts from the second largest acute-care hospital in Singapore and in the hospitals of two Danish regions included patients aged 15 and above who were admitted from 1 January 2006 to 31 December 2016 with at least 1 day of hospital stay and a pathogenic organism identified.

View Article and Find Full Text PDF
Article Synopsis
  • A study was conducted in two ICUs in Brazil to examine how delirium severity affects outcomes in critically ill COVID-19 patients.
  • Of the 277 patients assessed, 36.5% experienced delirium which was linked to longer ICU stays and higher mortality rates.
  • The findings suggest that higher delirium severity correlates with worse outcomes, including increased risk of coma and the need for mechanical ventilation.
View Article and Find Full Text PDF

Community acquired pneumonia (CAP) is a prevalent infectious disease often requiring hospitalization, although its diagnosis remains challenging as there is no gold standard test. In severe CAP, clinical and radiologic criteria have poor sensitivity and specificity, and microbiologic documentation is usually delayed and obtained in less than half of sCAP patients. Biomarkers could be an alternative for diagnosis, treatment monitoring and establish resolution.

View Article and Find Full Text PDF

Background: Immunomodulatory therapy has been extensively studied in randomized clinical trials for the treatment of patients hospitalized for COVID-19 with inconsistent findings. Guideline committees, reviewing the same clinical trial data, have generated different recommendations for immunomodulatory therapy.

Objectives: We hypothesize that trial design differences, specifically whether the study utilized an open-label or placebo-controlled design, accounted for the inconsistent mortality effects reported in clinical trials of immunomodulator therapies for COVID-19.

View Article and Find Full Text PDF

Introduction: Platelet transfusions are frequently used in intensive care unit (ICU) patients, but contemporary epidemiological data are sparse. We aim to present contemporary international data on the use of platelet transfusions in adult ICU patients with thrombocytopenia.

Methods: This is a protocol and statistical analysis plan for a post hoc sub-study of 504 thrombocytopenic patients from the 'Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)'.

View Article and Find Full Text PDF

We developed four algorithms for the automatic capture of C-reactive protein (CRP) peaks in 296 adult patients with acute myeloid leukemia who had bloodstream infection (BSI) episodes, negative blood cultures (BCs) or possible infections where no BCs were performed. The algorithms detected CRP peaks for 418-446 of the 586 documented BSI episodes (71.3-76.

View Article and Find Full Text PDF