Publications by authors named "Tiago Henrique De Souza"

Article Synopsis
  • A study evaluated how inflammation impacts the choice between standard and customized parenteral nutrition (PN) for hospitalized adolescents in Brazil, focusing on individual clinical and nutritional needs.
  • Out of 61 teens analyzed, 128 PN solutions were prescribed, with a majority requiring customization mainly to restore energy-protein adequacy.
  • The findings suggested that addressing malnutrition and inflammation through customized PN is essential for improving nutritional status and reducing further adjustments needed during treatment.
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Monitoring central venous pressure (CVP) is crucial for managing critically ill patients yet poses challenges in pediatric cases. This study aimed to correlate CVP with hepatic vein Doppler and IVC ultrasound variables in children. Mechanically ventilated children underwent simultaneous ultrasound and CVP measurements.

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Background: Positive end-expiratory pressure (PEEP) is widely used to improve oxygenation and avoid alveolar collapse in mechanically ventilated patients with pediatric acute respiratory distress syndrome (PARDS). However, its improper use can be harmful, impacting variables associated with ventilation-induced lung injury, such as mechanical power (MP) and driving pressure (∆P). Our main objective was to assess the impact of increasing PEEP on MP and ∆P in children with PARDS.

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Article Synopsis
  • Critically ill pediatric patients often face fluid accumulation (FA) due to administered fluids, which can lead to severe health complications and worsen outcomes.
  • A systematic review and meta-analysis of 120 studies involving 44,682 children showed that FA significantly increased the risks of mortality, acute kidney injury, prolonged mechanical ventilation, and longer ICU stays.
  • The findings suggest that careful monitoring and management of fluid levels in these patients is crucial to improve their overall health outcomes.
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Cardiac output is an essential determinant of oxygen delivery, although unreliably measured on clinical examination and routine monitoring. Unfortunately, cardiac output monitoring is rarely performed in pediatric critical care medicine, with a limited availability of accurate methods for children. Herein, we report two pediatric cases in which noninvasive pulse-wave transit time-based cardiac output monitoring (esCCO, Nihon Kohden, Tokyo, Japan) was used.

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Background: Point-of-care ultrasonography (POCUS) is proposed as a valuable method for hemodynamic monitoring and several ultrasound-based predictors of fluid responsiveness have been studied. The main objective of this study was to assess the accuracy of these predictors in children.

Methods: PubMed, Embase, Scopus, ClinicalTrials.

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Background: Renal resistive index (RRI) and renal pulsatility index (RPI) are Doppler-based variables proposed to assess renal perfusion at the bedside in critically ill patients. This study aimed to assess the accuracy of such variables to predict acute kidney injury (AKI) in mechanically ventilated children.

Methods: Consecutive children aged <14 years underwent kidney Doppler ultrasound examination within 24 h of invasive mechanical ventilation.

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Background: The use of checklists in the pediatric intensive care unit can help improve the quality of care and patient safety.

Objectives: To build and validate a checklist for use in interprofessional rounds in a pediatric intensive care unit.

Methods: This methodological study was conducted in a 20-bed pediatric intensive care unit serving children up to 14 years old.

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Aims: The aim of this study was to investigate whether respiratory variations in carotid and aortic blood flows measured by Doppler ultrasonography could accurately predict fluid responsiveness in critically ill children.

Methods: This was a prospective single-center study including mechanically ventilated children who underwent fluid replacement at the discretion of the attending physician. Response to fluid load was defined by a stroke volume increase of more than 15%.

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Background: Hypophosphatemia(HP) is related to several comorbidities in pediatric intensive care units (PICUs). This study aimed to evaluate the incidence of HP in severely ill pediatric patients receiving oral and/or enteral nutrition. The secondary objectives were to investigate the association between HP and the inflammatory state, PICU length of stay, severity, mortality, nutrition status, and protein, energy, calcium, vitamin D, and phosphate intake.

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For extubation in pediatric patients, the evaluation of readiness is strongly recommended. However, a device or practice that is superior to clinical judgment has not yet been accurately determined. Thus, it is important to conduct a review on the techniques of choice in clinical practice to predict extubation failure in pediatric patients.

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Objective: To evaluate the influence of intra-abdominal pressure on the cardiac index (CI) at different intra-abdominal hypertension grades achieved when performing an abdominal compression maneuver (ACM). Evaluating the effectiveness of the ACM in distending the left internal jugular vein (LIJV).

Methods: Prospective observational study conducted in the PICU of a quaternary care teaching hospital.

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Background & Aims: Adequate energy-protein intake is associated with improved clinical outcomes in critically ill children. The aim of this study was to evaluate the time of enteral nutrition (EN) onset and the energy-protein intake in critically ill pediatric patients admitted with respiratory insufficiency.

Methods: A single-center prospective cohort study, including children and adolescents, aged from 1 month to 14 years.

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The objective of this study was to evaluate the interoperator agreement of lung ultrasonography (LUS) on specific thoracic regions in children diagnosed with pneumonia and to compare the findings of the LUS with the chest X-ray. Participants admitted to the ward or PICU underwent LUS examinations performed by an expert and a novice operator. A total of 261 thoracic regions in 23 patients were evaluated.

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Unlabelled: : media-1vid110.1542/5828324804001PEDS-VA_2018-1719 CONTEXT: Central venous catheterization is routinely required in patients who are critically ill, and it carries an associated morbidity. In pediatric patients, the procedures can be difficult and challenging, predominantly because of their anatomic characteristics.

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Objective: To report a rare case of a child with invasive pneumococcal disease that presented meningitis associated with pericarditis.

Case Description: This report describes the unfavorable clinical course of a previously healthy 6-months-old female infant who initially presented symptoms of fever and respiratory problems. A chest X-ray revealed an increased cardiac area with no radiographic changes in the lungs.

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Objective: We investigated whether ultrasound guidance was advantageous over the anatomical landmark technique when performed by inexperienced paediatricians.

Design: Randomised controlled trial.

Setting: A paediatric intensive care unit of a teaching hospital.

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