Publications by authors named "Thiago Domingos Correa"

Objective: To evaluate the risk factors for healthcare-related infections during the COVID-19 pandemic in intensive care units, to investigate the impact of COVID-19 on Central Line-Associated Bloodstream Infection, Catheter-Associated Urinary Tract Infection, and ventilator-associated pneumonia, and to describe healthcare-associated infections in the waves of the COVID-19 pandemic.

Methods: This nested case-control study was conducted in a 137-bed adult medical/surgical intensive care unit at a private hospital in São Paulo, Brazil, between January 11, 2019, and May 21, 2022. Case patients were identified using the Nosocomial Infection Control Committee database and control patients were identified using the intensive care unit's EPIMED system.

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Article Synopsis
  • Point-of-care ultrasonography (POCUS) is becoming essential in critical care because it allows for rapid decision-making without needing to transfer patients out of the ICU, reducing risks and delays.* -
  • While CT scans are still standard for many conditions, POCUS enhances the safety of invasive procedures in the ICU, such as placing vascular catheters and draining fluid collections.* -
  • In nephrology, POCUS provides valuable diagnostic insights for acute kidney injury, helping to quickly rule out conditions like hydronephrosis and gather crucial hemodynamic information for personalized treatment.*
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Background: Critical illness is a major ongoing health care burden worldwide and is associated with high mortality rates. Sodium-glucose cotransporter-2 inhibitors have consistently shown benefits in cardiovascular and renal outcomes. The effects of sodium-glucose cotransporter-2 inhibitors in acute illness have not been properly investigated.

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Objective: The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care unit stay.

Methods: Conventional coagulation and platelet function tests, fibrinolysis, endogenous inhibitors of coagulation tests, and rotational thromboelastometry were conducted on days 0, 1, 3, 7, and 14 following intensive care unit admission.

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  • In Brazil, a study revealed a significant reduction in complications and death rates among high-risk surgical patients admitted to ICUs over a 10-year period, comparing cohorts from 2008 and 2018.
  • Analysis of 704 patients showed that the 2008 cohort had more postoperative infections and complications, while improvements in patient management were noted in the 2018 cohort.
  • Key factors linked to increased hospital mortality included high fluid balance, elevated creatinine levels, and intraoperative blood transfusions, whereas higher mean arterial pressure was associated with decreased mortality risk.
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Objective: To describe and compare the clinical characteristics and outcomes of patients admitted to intensive care units during the first and second waves of the COVID-19 pandemic.

Methods: In this retrospective single-center cohort study, data were retrieved from the Epimed Monitor System; all adult patients admitted to the intensive care unit between March 4, 2020, and October 1, 2021, were included in the study. We compared the clinical characteristics and outcomes of patients admitted to the intensive care unit of a quaternary private hospital in São Paulo, Brazil, during the first (May 1, 2020, to August 31, 2020) and second (March 1, 2021, to June 30, 2021) waves of the COVID-19 pandemic.

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  • The study aimed to investigate the impact of using balanced solutions compared to saline on short-term outcomes for traumatic brain injury patients in the BaSICS trial.
  • A total of 483 patients were enrolled, with findings indicating that those receiving balanced solutions had a high probability of increased 90-day mortality and fewer days free from intensive care.
  • The conclusion suggests a strong link between balanced solution use and worse outcomes, especially for patients with more severe brain injuries (Glasgow coma scale score ≤ 6).
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Objective: The main objective was to assess the clinical characteristics, associated factors, and outcomes of patients admitted to the ICU for candidemia. The secondary objective was to examine the relationship of candidemia with the length of stay and mortality.

Methods: The analysis was a retrospective single-center cohort study addressing the effect of invasive candidemia on outcomes.

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Ketamine is unique among anesthetics and analgesics. The drug is a rapid-acting general anesthetic that produces an anesthetic state characterized by profound analgesia, preserved pharyngeal-laryngeal reflexes, normal or slightly enhanced skeletal muscle tone, cardiovascular and respiratory stimulation, and occasionally a transient and minimal respiratory depression. Research has demonstrated the efficacy of its use on anesthesia, pain, palliative care, and intensive care.

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Background: Severe coronavirus disease 2019 (COVID-19) patients frequently require mechanical ventilation (MV) and undergo prolonged periods of bed rest with restriction of activities during the intensive care unit (ICU) stay. Our aim was to address the degree of mobilization in critically ill patients with COVID-19 undergoing to MV support.

Methods: Retrospective single-center cohort study.

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Objective: To evaluate clinical practices and hospital resource organization during the early COVID-19 pandemic in Brazil.

Methods: This was a multicenter, cross-sectional survey. An electronic questionnaire was provided to emergency department and intensive care unit physicians attending COVID-19 patients.

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Objective: The TELE-critical Care verSus usual Care On ICU PErformance (TELESCOPE) trial aims to assess whether a complex telemedicine intervention in intensive care units, which focuses on daily multidisciplinary rounds performed by remote intensivists, will reduce intensive care unit length of stay compared to usual care.

Methods: The TELESCOPE trial is a national, multicenter, controlled, open label, cluster randomized trial. The study tests the effectiveness of daily multidisciplinary rounds conducted by an intensivist through telemedicine in Brazilian intensive care units.

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  • Antibiotics misuse and overuse, particularly in low and middle-income countries, is leading to rising antimicrobial resistance.
  • Antimicrobial stewardship programs are an effective strategy to minimize unnecessary antibiotic prescriptions, specifically for polymyxins and carbapenems.
  • The review emphasizes the use of cumulative antibiograms and biomarkers to facilitate quicker de-escalation of antibiotic treatments.
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Background: Coexistence of cancer and COVID-19 is associated with worse outcomes. However, the studies on cancer-related characteristics associated with worse COVID-19 outcomes have shown controversial results. The objective of the study was to evaluate cancer-related characteristics associated with invasive mechanical ventilation use or in-hospital mortality in patients with COVID-19 admitted to intensive care unit (ICU).

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Objective: To describe clinical characteristics, resource use, outcomes, and to identify predictors of in-hospital mortality of patients with COVID-19 admitted to the intensive care unit.

Methods: Retrospective single-center cohort study conducted at a private hospital in São Paulo (SP), Brazil. All consecutive adult (≥18 years) patients admitted to the intensive care unit, between March 4, 2020 and February 28, 2021 were included in this study.

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Background And Objectives: Hypothermia occurs commonly during surgery and can cause postoperative complications. We aimed to describe the characteristics and outcomes of hypothermia in patients undergoing major surgeries.

Methods: This prospective, observational, multicenter study of a nationally representative sample included all patients over 18 years of age admitted to an intensive care unit (ICU).

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Background And Objectives: Patients who develop post-operative acute kidney injury (AKI) have a poor prognosis, especially when undergoing high-risk surgery. Therefore, the objective of this study was to evaluate the outcome of patients with AKI acquired after non-cardiac surgery and the possible risk factors for this complication.

Methods: A multicenter, prospective cohort study with patients admitted to intensive care units (ICUs) after non-cardiac surgery was conducted to assess whether they developed AKI.

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Background: Mechanical ventilation can injure lung tissue and respiratory muscles. The aim of the present study is to assess the effect of the amount of spontaneous breathing during mechanical ventilation on patient outcomes.

Methods: This is an analysis of the database of the 'Medical Information Mart for Intensive Care (MIMIC)'-III, considering intensive care units (ICUs) of the Beth Israel Deaconess Medical Center (BIDMC), Boston, MA.

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Objective: To investigate the impact of intensive care unit admission during medical handover on mortality.

Methods: Post-hoc analysis of data extracted from a prior study aimed at addressing the impacts of intensive care unit readmission on clinical outcomes. This retrospective, single-center, propensity-matched cohort study was conducted in a 41-bed general open-model intensive care unit.

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