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  1. Article ; Online: The risks of the new morbidities acquired during pediatric onco-critical care and their life-shortening effects.

    Santos, Gabriela Maria Virgílio Dias / de Araujo, Orlei Ribeiro / Leal, Priscila de Biasi / Arduini, Rodrigo Genaro / de Sousa, Rosa Massa Kikuchi / Caran, Eliana Maria Monteiro / da Silva, Dafne Cardoso Bourguignon

    Jornal de pediatria

    2023  Volume 99, Issue 6, Page(s) 568–573

    Abstract: Objective: The authors investigated the functional status at ICU admission and at hospital discharge, and the impact of dysfunctions on survivors' lifespan.: Method: Single-center retrospective cohort. The FSS (Functional Status Scale) was calculated ...

    Abstract Objective: The authors investigated the functional status at ICU admission and at hospital discharge, and the impact of dysfunctions on survivors' lifespan.
    Method: Single-center retrospective cohort. The FSS (Functional Status Scale) was calculated at ICU admission and at hospital discharge. A new morbidity was defined as an increase in FSS ≥ 3.
    Results: Among 1002 patients, there were 855 survivors. Of these, 194 (22.6%) had died by the end of the study; 45 (5.3%) had a new morbidity. Means in the motor domain at admission and discharge were 1.37 (SD: 0.82) and 1.53 (SD 0.95, p = 0.002). In the feeding domain, the means were 1.19 (SD 0.63) and 1.30 (SD 0.76), p = 0.002; global means were 6.93 (SD 2.45) and 7.2 (SD 2.94), p = 0.007.  Acute respiratory failure requiring mechanical ventilation, the score PRISM IV, age < 5 years, and central nervous system tumors were independent predictors of new morbidity. New morbidity correlated with lower odds of survival after hospital discharge, considering all causes of death (p = 0.014), and was independently predictive of death (Cox hazard ratio = 1.98). In Weibull models, shortening in the life span of 14.2% (p = 0.014) was estimated as a new morbidity.
    Conclusions: New morbidities are related to age, disease severity at admission, and SNC tumors. New morbidities, in turn, correlate with lower probabilities of survival and shortening of the remaining life span. Physical rehabilitation interventions in this population of children may have the potential to provide an increase in lifespan.
    MeSH term(s) Child ; Humans ; Child, Preschool ; Retrospective Studies ; Critical Care ; Morbidity ; Hospitalization ; Patient Discharge
    Language English
    Publishing date 2023-06-22
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 731324-x
    ISSN 1678-4782 ; 0021-7557
    ISSN (online) 1678-4782
    ISSN 0021-7557
    DOI 10.1016/j.jped.2023.05.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: ALVEOLAR RECRUITMENT MANEUVERS FOR CHILDREN WITH CANCER AND ACUTE RESPIRATORY DISTRESS SYNDROME: A FEASIBILITY STUDY.

    Galassi, Marcela Salvador / Arduini, Rodrigo Genaro / Araújo, Orlei Ribeiro de / Sousa, Rosa Masssa Kikuchi / Petrilli, Antonio Sergio / Silva, Dafne Cardoso Bourguignon da

    Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo

    2021  Volume 39, Page(s) e2019275

    Abstract: Objective: Acute respiratory distress syndrome (ARDS) can be a devastating condition in children with cancer and alveolar recruitment maneuvers (ARMs) can theoretically improve oxygenation and survival. The study aimed to assess the feasibility of ARMs ... ...

    Abstract Objective: Acute respiratory distress syndrome (ARDS) can be a devastating condition in children with cancer and alveolar recruitment maneuvers (ARMs) can theoretically improve oxygenation and survival. The study aimed to assess the feasibility of ARMs in critically ill children with cancer and ARDS.
    Methods: We retrospectively analyzed 31 maneuvers in a series of 12 patients (median age of 8.9 years) with solid tumors (n=4), lymphomas (n=2), acute lymphoblastic leukemia (n=2), and acute myeloid leukemia (n=4). Patients received positive end-expiratory pressure from 25 up to 40 cmH20, with a delta pressure of 15 cmH2O for 60 seconds. We assessed blood gases pre- and post-maneuvers, as well as ventilation parameters, vital signs, hemoglobin, clinical signs of pulmonary bleeding, and radiological signs of barotrauma. Pre- and post-values were compared by the Wilcoxon test.
    Results: Median platelet count was 53,200/mm3. Post-maneuvers, mean arterial pressure decreased more than 20% in two patients, and four needed an increase in vasoactive drugs. Hemoglobin levels remained stable 24 hours after ARMs, and signs of pneumothorax, pneumomediastinum, or subcutaneous emphysema were absent. Fraction of inspired oxygen decreased significantly after ARMs (FiO2; p=0.003). Oxygen partial pressure (PaO2)/FiO2 ratio increased significantly (p=0.0002), and the oxygenation index was reduced (p=0.01), but all these improvements were transient. Recruited patients' 28-day mortality was 58%.
    Conclusions: ARMs, although feasible in the context of thrombocytopenia, lead only to transient improvements, and can cause significant hemodynamic instability.
    MeSH term(s) Blood Gas Analysis ; Child ; Feasibility Studies ; Health Services Accessibility ; Humans ; Neoplasms/complications ; Positive-Pressure Respiration/adverse effects ; Positive-Pressure Respiration/methods ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy ; Retrospective Studies
    Language Portuguese
    Publishing date 2021-01-11
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2560228-7
    ISSN 1984-0462 ; 1984-0462
    ISSN (online) 1984-0462
    ISSN 1984-0462
    DOI 10.1590/1984-0462/2021/39/2019275
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Sepsis-related acute respiratory distress syndrome in children with cancer: the respiratory dynamics of a devastating condition.

    Arduini, Rodrigo Genaro / Araujo, Orlei Ribeiro de / Silva, Dafne Cardoso Bourguignon da / Senerchia, Andreza Almeida / Petrilli, Antonio Sergio

    Revista Brasileira de terapia intensiva

    2016  Volume 28, Issue 4, Page(s) 436–443

    Abstract: Objective:: To evaluate the clinical course and respiratory parameters of mechanically ventilated children with cancer suffering from sepsis-related acute respiratory distress syndrome.: Methods:: This 2-year prospective, longitudinal, observational ... ...

    Title translation Síndrome do desconforto respiratório agudo relacionada à sepse em crianças com câncer: dinâmica respiratória de uma condição devastadora.
    Abstract Objective:: To evaluate the clinical course and respiratory parameters of mechanically ventilated children with cancer suffering from sepsis-related acute respiratory distress syndrome.
    Methods:: This 2-year prospective, longitudinal, observational cohort study enrolled 29 children and adolescents. Clinical data, measurements of blood gases and ventilation parameters were collected at four different time points. Fluctuations between measurements as well as differences in estimated means were analyzed by linear mixed models in which death within 28 days from the onset of acute respiratory distress syndrome was the primary endpoint.
    Results:: There were 17 deaths within 28 days of acute respiratory distress syndrome onset and another 7 between 29 - 60 days. Only 5 patients survived for more than 60 days. Nine (31%) patients died as a direct consequence of refractory hypoxemia, and the others died of multiple organ failure and catecholamine-refractory shock. In 66% of the measurements, the tidal volume required to obtain oxygen saturation equal to or above 90% was greater than 7mL/kg. The estimated means of dynamic compliance were low and were similar for survivors and non-survivors but with a negative slope between the first and final measurements, accompanied by a negative slope of the tidal volume for non-survivors. Non-survivors were significantly more hypoxemic, with PaO2/FiO2 ratios showing lower estimated means and a negative slope along the four measurements. Peak, expiratory and mean airway pressures showed positive slopes in the non-survivors, who also had more metabolic acidosis.
    Conclusions:: In most of our children with cancer, sepsis and acute respiratory distress syndrome progressed with deteriorating ventilation indexes and escalating organic dysfunction, making this triad nearly fatal in children.
    MeSH term(s) Blood Gas Analysis ; Child ; Child, Preschool ; Cohort Studies ; Disease Progression ; Female ; Humans ; Linear Models ; Longitudinal Studies ; Male ; Multiple Organ Failure/epidemiology ; Multiple Organ Failure/etiology ; Multiple Organ Failure/mortality ; Neoplasms/complications ; Prospective Studies ; Respiration, Artificial ; Respiratory Distress Syndrome/epidemiology ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/mortality ; Sepsis/complications ; Sepsis/epidemiology ; Tidal Volume ; Time Factors
    Language English
    Publishing date 2016-12-22
    Publishing country Brazil
    Document type Journal Article ; Observational Study
    ZDB-ID 2732162-9
    ISSN 1982-4335 ; 1982-4335
    ISSN (online) 1982-4335
    ISSN 1982-4335
    DOI 10.5935/0103-507X.20160077
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Comparative study of the neuropsychological and neuroimaging evaluations in children with dyslexia.

    Arduini, Rodrigo Genaro / Capellini, Simone Aparecida / Ciasca, Sylvia Maria

    Arquivos de neuro-psiquiatria

    2006  Volume 64, Issue 2B, Page(s) 369–375

    Abstract: We analyzed retrospectively the neuroimaging exams of children with a confirmed diagnosis of dyslexia and correlated our findings with the evaluation of higher cortical functions. We studied 34 medical files of patients of the Ambulatory of Neuro- ... ...

    Abstract We analyzed retrospectively the neuroimaging exams of children with a confirmed diagnosis of dyslexia and correlated our findings with the evaluation of higher cortical functions. We studied 34 medical files of patients of the Ambulatory of Neuro-difficulties in Learning, FCM/UNICAMP. All of them had been sent to the ambulatory with primary or secondary complaints of difficulties at school and were submitted to neuropsychological evaluation and imaging exam (SPECT). From the children evaluated 58.8% had exams presenting dysfunction with 47% presenting hypoperfusion in the temporal lobe. As for the higher cortical functions, the most affected abilities were reading, writing and memory. There was significance between the hypoperfused areas and the variables schooling, reading, writing, memory and mathematic reasoning. The SPECTs showed hypoperfusion in areas involved in the reading and writing processes. Both are equivalent in terms of involved functional areas and are similar in children with or without specific dysfunctions in neuroimaging.
    MeSH term(s) Adolescent ; Child ; Child, Preschool ; Dyslexia/diagnosis ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Neuropsychological Tests ; Retrospective Studies ; Tomography, Emission-Computed, Single-Photon
    Language English
    Publishing date 2006-06-09
    Publishing country Brazil
    Document type Comparative Study ; Journal Article
    ZDB-ID 418916-4
    ISSN 0004-282X
    ISSN 0004-282X
    DOI 10.1590/s0004-282x2006000300004
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    In stock of ZB MED Cologne/Königswinter

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  5. Article: Red blood cell transfusion practice in a Pediatric Intensive Care Unit.

    Mendes, Cibele / Silva, Dafne Cardoso Bourguignon da / Arduini, Rodrigo Genaro / Troster, Eduardo Juan

    Einstein (Sao Paulo, Brazil)

    2011  Volume 9, Issue 2, Page(s) 135–139

    Abstract: Objectives: To describe a population of children that received red blood cell transfusions.: Methods: A retrospective observational study carried out at the Pediatric Intensive Care Unit of the Instituto da Criança of Hospital das Clínicas of ... ...

    Abstract Objectives: To describe a population of children that received red blood cell transfusions.
    Methods: A retrospective observational study carried out at the Pediatric Intensive Care Unit of the Instituto da Criança of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo in 2004, with children that received red blood cell transfusions.
    Results: Transfusion of red blood cells was performed in 50% of the patients hospitalized. Median age was 18 months, and the primary motive for admission was respiratory insufficiency (35%). Underlying disease was present in 84% of the cases and multiple organ and system dysfunction in 46.2%. The median value of pretransfusion hemoglobin concentration was 7.8 g/dL. Transfused patients were undergoing some form of therapeutic procedure in 82% of the cases.
    Conclusions: Red blood cell transfusions are performed at all ages. Hemoglobin concentration and hematocrit rate are the primary data used to indicate these transfusions. The values of arterial serum lactate and SvO2were seldom used. Most patients transfused were submitted to some form of therapeutic procedure, and in many cases, transfusions were carried out in patients with multiple organ and system dysfunctions.
    Language Portuguese
    Publishing date 2011-06
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2418293-X
    ISSN 2317-6385 ; 1679-4508
    ISSN (online) 2317-6385
    ISSN 1679-4508
    DOI 10.1590/S1679-45082011AO1884
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  6. Article ; Online: Vancomycin serum concentrations in pediatric oncologic/hematologic intensive care patients.

    Silva, Dáfne Cardoso Bourguignon da / Seixas, Gláucia Toribio Finoti / Araujo, Orlei Ribeiro de / Arduini, Rodrigo Genaro / Carlesse, Fabianne Altruda de Moraes Costa / Petrilli, Antonio Sergio

    The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases

    2012  Volume 16, Issue 4, Page(s) 361–365

    Abstract: Background: Usual treatment regimens with vancomycin often fail to provide adequate serum levels in patients with severe infections.: Methods: Retrospective analysis of vancomycin trough serum measurements. The following parameters were calculated by ...

    Abstract Background: Usual treatment regimens with vancomycin often fail to provide adequate serum levels in patients with severe infections.
    Methods: Retrospective analysis of vancomycin trough serum measurements. The following parameters were calculated by Bayesian analysis: vancomycin clearance, distribution volume, and peak estimated concentrations. The area under the concentration curve (AUC) (total daily dose/24 h clearance of vancomycin) was used to determine the effectiveness of treatment through the ratio of AUC/minimum inhibitory concentration (MIC) above 400, using MIC=1 μg/mL, based on isolates of Staphylococci in cultures.
    Results: Sixty-one vancomycin trough measurements were analyzed in 31 patients. AUC/MIC>400 was obtained in 34 out of 61 dosages (55.7%), but the mean vancomycin dose required to achieve these levels was 81 mg/kg/day. In cases where the usual doses were administered (40-60 mg/kg/day), AUC/MIC>400 was obtained in nine out of 18 dosages (50%), in 13 patients. Trough serum concentrations above 15 mg/L presented a positive predictive value of 100% and a negative predictive value of 71% for AUC/MIC>400.
    Conclusion: Higher than usual vancomycin doses may be required to treat staphylococcal infections in children with oncologic/hematologic diseases. Since the best known predictor of efficacy is the AUC/MIC ratio, serum trough concentrations must be analyzed in conjunction with MICs of prevalent Staphylococci and pharmacokinetic tools such as Bayesian analysis.
    MeSH term(s) Adolescent ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/blood ; Anti-Bacterial Agents/pharmacokinetics ; Area Under Curve ; Bayes Theorem ; Child ; Child, Preschool ; Critical Care ; Drug Dosage Calculations ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Neoplasms/virology ; Retrospective Studies ; Staphylococcal Infections/drug therapy ; Staphylococcus/drug effects ; Vancomycin/administration & dosage ; Vancomycin/blood ; Vancomycin/pharmacokinetics
    Chemical Substances Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
    Language English
    Publishing date 2012-07
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2041400-6
    ISSN 1678-4391 ; 1413-8670
    ISSN (online) 1678-4391
    ISSN 1413-8670
    DOI 10.1016/j.bjid.2012.06.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5633: Show issues Location:
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  7. Article ; Online: I diretriz brasileira de cardio-oncologia pediátrica da Sociedade Brasileira de Cardiologia.

    Seber, Adriana / Miachon, Adriana Siviero / Tanaka, Ana Cristina Sayuri / Spínola e Castro, Angela Maria / Carvalho, Antônio Carlos / Petrilli, Antônio Sergio / Macedo, Carla Renata Donato Pacheco / Nars, Clarissa Carvalho Fongaro / Terzian, Claudia Naufel / Castro Jr, Claudio Galvão de / Santos, Cleusa Cavalcanti Lapa / Guerra, Cristina Chaves dos Santos / Silva, Dafne Cardoso Bourguignon da / Bassi, Débora Ugayama / Azeka, Estela / Feitosa, Fabiana Aragão / Hamamoto, Fernando / Szarf, Gilberto / Lederman, Henrique Manoel /
    Rigon Jr, Humberto João / Jatene, Ieda Biscegli / Mota, Isabele Coelho Fonseca da / Perrud, Jeferson Adriano / Soares, José / Gutierrez, Julián Arango / Perin, Juliana Pepe Marinho / Soares, Juliana dos Santos / Catani, Liane Hulle / Tsai, Liliana Yu / Vianna, Livia Cristina / Paiva, Marcelo Goulart / Santos, Marcelo José / Ishigai, Marcia Marcelino de Souza / Diógenes, Maria Suely Bezerra / Alves, Maria Teresa de Seixas / Piedade, Maria Tereza Castro / Parreiras, Mariana / Cypriano, Mônica / Negrini, Nilce da Silva / Campos Filho, Orlando / Figueiredo, Paula Andrade / Novaes, Paulo Eduardo / Camargo, Paulo Roberto / Maia, Priscila dos Santos / Petrilli, Renata / Arduini, Rodrigo Genaro / Gouveia, Roseane Vasconcelos / Teruya, Suzana Barbosa Miranda / Moisés, Valdir Ambrosio / Morais, Vera Lúcia Lins de

    Arquivos brasileiros de cardiologia

    2013  Volume 100, Issue 5 Suppl 1, Page(s) 1–68

    Title translation First guidelines on pediatric cardio-oncology from the Brazilian Society of Cardiology.
    MeSH term(s) Adolescent ; Antineoplastic Agents/adverse effects ; Cardiotoxins/adverse effects ; Cardiovascular Diseases/chemically induced ; Child ; Evidence-Based Medicine ; Heart Neoplasms/etiology ; Heart Neoplasms/radiotherapy ; Humans ; Neoplasms/drug therapy ; Neoplasms/surgery
    Chemical Substances Antineoplastic Agents ; Cardiotoxins
    Language Portuguese
    Publishing date 2013-05
    Publishing country Brazil
    Document type Journal Article ; Practice Guideline
    ZDB-ID 730261-7
    ISSN 1678-4170 ; 0066-782X
    ISSN (online) 1678-4170
    ISSN 0066-782X
    DOI 10.5935/abc.2013S005
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