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  1. Article ; Online: Critical disease related to SARS-CoV-2 infection in children from the Amazon region: an observational study.

    Farias, Emmerson Carlos Franco de / Pavão Júnior, Manoel Jaime Castro / de Sales, Susan C D / do Nascimento, Luciana M P P / de Mello, Mary / Carvalho, Patricia / Terreri, Maria Teresa / Clemente, Gleice

    BMJ paediatrics open

    2023  Volume 7, Issue 1

    Abstract: This is a multicentre prospective cohort including critically ill children and adolescents, with confirmed critical disease related to SARS-CoV-2, admitted to three tertiary paediatric intensive care units in the Brazilian Amazon, between April 2020 and ... ...

    Abstract This is a multicentre prospective cohort including critically ill children and adolescents, with confirmed critical disease related to SARS-CoV-2, admitted to three tertiary paediatric intensive care units in the Brazilian Amazon, between April 2020 and July 2022. 208 patients were included (median age was 3.5 years). The majority had malnutrition (62%) and comorbidities (60.6%). Mechanical ventilation support, cardiogenic shock and acute respiratory distress syndrome occurred in 47%, 30% and 34.1% of patients, respectively. There were 37 (18%) deaths. A poor outcome of severe COVID-19 and multisystem inflammatory syndrome in children was observed in children and adolescents from the Brazilian Amazon.
    MeSH term(s) Adolescent ; Humans ; Child ; Child, Preschool ; COVID-19/epidemiology ; SARS-CoV-2 ; Prospective Studies ; Hospitalization
    Language English
    Publishing date 2023-04-26
    Publishing country England
    Document type Observational Study ; Letter
    ISSN 2399-9772
    ISSN (online) 2399-9772
    DOI 10.1136/bmjpo-2023-001865
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient.

    Machado-Ferraro, Kissila M / Soriano-de-Mello, Débora S / de Moura, Isadora P / da Silveira, Cinthia C S M / de Farias, Emmerson C F / Maia, Mary L F / de Sales, Susan C D / Carvalho, Ana Emilia V / Magno, Ismaelino M N / Fontes-Júnior, Enéas A / Maia, Cristiane S F

    Annals of translational medicine

    2022  Volume 10, Issue 2, Page(s) 113

    Abstract: This case report describes the long-term behavioral and cognitive alterations in a critically ill pediatric patient submitted to a ketamine sedation and analgesia protocol for 7 consecutive days in a pediatric intensive care unit. The infant exhibited ... ...

    Abstract This case report describes the long-term behavioral and cognitive alterations in a critically ill pediatric patient submitted to a ketamine sedation and analgesia protocol for 7 consecutive days in a pediatric intensive care unit. The infant exhibited withdrawal syndrome in the early withdrawal period, as measured using the Withdrawal Assessment Tool-1 (WAT-1). In the days following ketamine withdrawal, behavioral, motor, and cognitive impairment was observed, even after hospital discharge. At 20 days after admission to hospital, the infant still displayed language deficits compatible with the at-risk category for the appropriate age group on the development assessment (Denver-II Developmental Screening Test). The infant's mother reported that these impairments were not present before ketamine sedation. We therefore suggest that prolonged ketamine use may have contributed to the long-lasting behavioral and cognitive impairments observed in the critically ill infant. These adverse effects may be attributable to ketamine's pharmacological mechanism of action, by which the N-methyl-D-aspartate receptor-the central nervous system excitatory receptor responsible for memory and learning domains-is blockaded, disrupting long-term potentiation events. Our case highlights the need for clinical evaluation of ketamine agents and their associated risks in intensive care units to better clarify appropriate sedative and analgesic agents during neurodevelopmental periods of life.
    Language English
    Publishing date 2022-03-03
    Publishing country China
    Document type Case Reports
    ZDB-ID 2893931-1
    ISSN 2305-5847 ; 2305-5839
    ISSN (online) 2305-5847
    ISSN 2305-5839
    DOI 10.21037/atm-21-2292
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting.

    de Farias, Emmerson C F / Pavão Junior, Manoel J C / de Sales, Susan C D / do Nascimento, Luciana M P P / Pavão, Dalila C A / Pinheiro, Anna P S / Pinheiro, Andreza H O / Alves, Marília C B / Ferraro, Kíssila M M M / Aires, Larisse F Q / Dias, Luana G / Machado, Mayara M M / Serrão, Michaelle J D / Gomes, Raphaella R / de Moraes, Sara M P / Moura, Gabriella M G / de Sousa, Adriana M B / Pontes, Gabriela C L / Carvalho, Railana D F P /
    Silva, Cristiane T C / Lemes, Guilherme / da C G Diniz, Bruna / Chermont, Aurimery G / de Almeida, Kellen F S / Saraty, Salma B / Maia, Mary L F / Lima, Miriam R C / Carvalho, Patricia B / de B Braga, Renata / de O Harada, Kathia / Justino, Maria C A / Clemente, Gleice / Terreri, Maria Teresa / Monteiro, Marta C

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 5539

    Abstract: SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C ... ...

    Abstract SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo-18 years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023. The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23 months, 95 (50.8%) were up to 2 years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11 days (IQR, 2-28). In the MIS-C group, 56 (70.9%) were male, median age was 23 months and median follow-up was 162 days (range, 3-202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4-13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12 days of hospitalization.
    MeSH term(s) Child ; Humans ; Male ; Infant ; Child, Preschool ; Female ; Critical Illness ; Prospective Studies ; COVID-19/epidemiology ; COVID-19/complications ; SARS-CoV-2 ; Connective Tissue Diseases ; Systemic Inflammatory Response Syndrome
    Language English
    Publishing date 2024-03-06
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-55065-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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