UCI PED - Artigos
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- Croup and COVID‐19Publication . Almendra, M; Pereira, MP; Gonçalves, CS; Bonfadini, M; Brites, V; Estrada, JF
- Pediatric Organ and Tissue Donation—A 10-Year Retrospective Study in PortugalPublication . Pais de Faria, J; Oliveira, M; Rodrigues, F; Xavier, MJ; Pico, P; Estrada, JOrgan and tissue donation can transform lives. One donor can ensure the survival of up to 8 people through their organs and improve the quality of life for dozens more through tissue donation. Portugal has an excellent transplantation rate, but deaths still occur while waiting for an organ. The study aimed to analyze pediatric organ and tissue donors nationally and evaluate brain deaths in a pediatric intensive care unit (PICU) over the past 10 years to identify any potential lost donors. We conducted a retrospective descriptive study of pediatric organ and tissue donors and diagnosed brain deaths from January 2011 to December 2021. Demographic and clinical data were analyzed, including those provided by the National Transplant Coordination. Over the past 10 years in Portugal, 121 pediatric donors (11.7 per million population) were collected, and 569 organs and tissues were collected. During the same period in the PICU, there were 125 deaths, including 20 brain deaths. Of this group, 4 were organ and tissue donors. In the non-donor group (n = 16), a potential lost donor case stands out. Pediatric specialists need to be more familiar with the donation process, which would enable the identification and optimization of all potential donors, thus minimizing the number of potentially lost organs.
- Cardiac Injury and Vasoplegia in Critically ill Children due to Multisystem Inflammatory Syndrome in Children Associated with COVID-19Publication . Constante, AD; Garcia, AM; Pataca, IC; Salva, I; Trigo, C; Brito, MJ
- Coexistence of Pheochromocytoma and Renal Artery Stenosis in a Pediatric Patient with HypertensionPublication . Serras, I; Baeta Baptista, R; Francisco, T; Casimiro, A; Lito, D; Alves, R; Abranches, MPheochromocytoma and renal artery stenosis are surgically treatable causes of hypertension. Although rare, the coexistence of pheochromocytoma and renal artery stenosis has been described in case reports. Common pathophysiological mechanisms other than extrinsic compression may be involved in this association, such as catecholamine-induced vasospasm. The early recognition of the association of pheochromocytoma with renal artery stenosis is essential for appropriate treatment planning. We present the case of a previously healthy tenyear- old boy who presented with hypertensive encephalopathy, tachycardia and diaphoresis. Hypertension was found to be secondary to a catecholamine-producing tumor associated with coexisting renal artery stenosis. Hypertension resolved a few months after successful pheochromocytoma excision, without renal artery revascularization.
- O Direito de Brincar...Também nos Cuidados IntensivosPublication . Abreu, C; Correia, F; Jácome, P; Rodrigues, S; Santos, VO acto de brincar apresenta-se como um importante recurso para promover o desenvolvimento e o bem estar da criança, assim como, facilitar a compreensão do mundo que a rodeia. Em contexto de internamento em cuidados intensivos pediátricos, o brincar é uma estratégia efectiva de intervenção de enfermagem pediátrica para ultrapassar as barreiras da hospitalização.A reflexão sobre esta problemática resulta da prática clínica numa Unidade de Cuidados Intensivos (UCI) onde os enfermeiros se constituem como os principais promotores desta actividade.
- Nonlethal, Attenuated, Transfusion-Associated Graft-Versus-Host Disease in an Immunocompromised Child: Case Report and Review of the LiteraturePublication . Farela Neves, J; Marques, A; Valente, R; Barata, DTransfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication of transfusion of nonirradiated blood components. It usually affects children in high-risk groups, including those who have primary immunodeficiencies (PIDs). It usually presents with skin, hepatic, digestive, and hematologic involvement and is normally fatal.
- Anti-N-Methyl-D-Aspartate Receptor Encephalitis with Positive Serum Antithyroid Antibodies, IgM Antibodies Against Mycoplasma Pneumoniae and Human Herpesvirus 7 PCR in the CSFPublication . Venâncio, P; Brito, MJ; Pereira, G; Vieira, JPWe report the case of a boy with an encephalopathy associated with extrapyramidal and psychiatric symptoms and anti-N-methyl-D-aspartate receptor antibodies. He had positive serum antithyroid antibodies, IgM antibodies against Mycoplasma pneumoniae and human herpesvirus 7 polymerase chain reaction in the cerebrospinal fluid. He was successfully treated with rituximab, after steroids, intravenous immunoglobulin and plasma exchange. The pathophysiology of this disorder may be post-infectious and autoimmune.
- First Case of Severe Enterovirus 71 Infection in PortugalPublication . Venâncio, P; Oliveira, M; Silva, R; Conceição, C; Brito, MJ
- Methadone Intoxication in a Child: Toxic Encephalopathy?Publication . Anselmo, M; Campos Rainho, A; Vale, MC; Estrada, J; Valente, R; Correia, M; Vieira, JP; Barata, DMethadone is used in the treatment of opioid addiction. Acute intoxication can lead to severe consequences and can even be lethal. In several case reports and small series, a presumably toxic leukoencephalopathy is described resulting from inhalation of heroin. We present the case of a 3-year-old boy who ingested methadone accidentally. In a coma with acute obstructive hydrocephalus owing to massive cerebellar edema and supratentorial lesions, he was successfully treated with methylprednisolone and cerebrospinal fluid external drainage. To our knowledge, this is the first report of an encephalopathy associated with synthetic opioid intoxication.
- Grande Queimado numa Unidade de Cuidados Intensivos Pediátricos – Experiência de 20 AnosPublication . Francisco, T; Nóbrega, S; Valente, R; Santos, M; Pereira, G; Estrada, J; Serafim, Z; Ventura, LIntrodução: A abordagem inicial do grande queimado até à sua estabilização hemodinâmica e hidroeletrolítica é fundamental para diminuir a morbimortalidade. Material e Métodos: Estudo retrospectivo, descritivo e analítico, de todos os internamentos por queimadura numa Unidade de Cuidados Intensivos Pediátricos durante o período de 20 anos (Abril/1991 a Dezembro/2010). Avaliaram -se parâmetros nosodemográficos, agente causal, gravidade e extensão da queimadura, procedimentos, terapêutica, complicações e resultados. Resultados: Ocorreram 137 internamentos por queimadura correspondentes a 123 doentes e a 1,8% do total de internamentos na UCIP. A mediana de idade foi 3,6 anos e 62,4% era do sexo masculino. Verificou -se maior incidência em Agosto (13,0%). Foram agentes da queimadura: líquido fervente (38,1%), fogo (38,1%) e eletricidade (23,9%). A mediana da superfície corporal queimada foi de 30% (0,5 -92,0%), com queimaduras do terceiro grau em 59,0% dos doentes. Necessitaram de ventilação mecânica 45,5% e de cateter venoso central 64,2% dos doentes. As complicações incluíram: sépsis (29,2%), falência respiratória (21,1%), falência cardiovascular (16,5%) e falência multiorgânica (18,8%). Verificou -se melhoria em 88,6% dos casos e ocorreram 10 óbitos (8,1%), nove dos quais nos primeiros 10 anos do estudo e nove devido a causa infeciosa. No entanto, o score avaliador do risco de mortalidade (PRISM), índice de intervenção terapêutica (TISS) e o risco de probabilidade de morte (RPM) foram mais elevados no segundo decénio. Conclusões: Nos últimos anos do estudo, apesar do maior número de admissões e da sua maior gravidade, verificou -se uma diminuição do número de mortes, o que poderá dever-se à melhoria dos cuidados prestados.