HC - PN - Pediatria e Neonatologia
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- Segurança do doente pediátrico: a tecnologia como aliada no processo de administração de terapêuticaPublication . Costa, M; Trindade, D; Fernandes, P
- Eutectic mixture of local anesthetics’ dosage in newborns: a scoping review.Publication . Prior, F; Querido, D; Santos, IIntrodução: A Mistura Eutética de Anestésico Local (EMLA) está facilmente disponível, não sendo amplamente utilizado na população neonatal por falta de evidência quanto a uma dose adequada para administração. Objetivos: Identificar como o creme EMLA é utilizado para reduzir a dor, sem reação adversa, nos recém-nascidos sujeitos a procedimentos dolorosos. Métodos: Revisão scoping para mapear a literatura respeitante à população, conceito e contexto (PCC) em estudo, considerando literatura obtida de bases de dados científicas e literatura cinzenta publicada entre 2002 e 2021, com texto completo disponível e sem restrições de linguagem. Resultados: Doze documentos respeitantes a 2661 recém-nascidos – desde as 28 semanas de idade gestacional até recémnascidos de termo – considerando a eficácia e descrevendo a quantidade e tempo de contacto com a pele do EMLA creme. Oito protocolos recomendam o uso de penso oclusivo. Um documento descreveu reações de palidez e eritema na pele Conclusão: O EMLA é eficaz quando utilizado em recém-nascidos sujeitos a procedimentos dolorosos. A quantidade mais utilizada é de 0,5g em recém-nascidos pré-termo e 1g nos recém-nascidos de termo. O tempo mais frequente de contato com a pele é de 60 minutos. Sendo estas as dosagens mais frequentes, o intervalo identificado é de 0,5 a 2g na quantidade utilizada, e o tempo de contato com a pele de 3 a 180 minutos. A utilização de penso oclusivo é descrita na maioria dos protocolos.
- Programa de Treino de Suporte Básico de Vida Pediátrico: uma experiência de prática simuladaPublication . Prior, F; Monteiro, F; Costa, M; Carneiro, R; Hneriques, Pntrodução: A equipa de enfermagem da Unidade de Cuidados Intermédios de Pediatria identificou a necessidade de aumentar a confiança da equipa na realização de manobras de reanimação à criança em estado crítico, tendo sido criado um Programa de Treino em Suporte Básico de Vida Pediátrico em 2 fases.Objetivo: Treinar em contexto de simulação clínica competências de Suporte Básico de Vida em pediatria.Métodos: Desenvolvimento de um programa de treino para a prática de competências de reanimação e treino do algoritmo do Suporte Básico de Vida Pediátrico.Resultados: Participaram no programa 94 formandos: 57 enfermeiros da Unidade de Cuidados Intermédios Pediátricos, Serviço de Obstetrícia e Pediatria; 5 estudantes da licenciatura em enfermagem; 1 estudante de ensino pós-graduado em enfermagem; e 31 assistentes operacionais da Unidade de Cuidados Intermédios de Pediatria, Serviço de Obstetrícia e Pediatria.Conclusão: Os formandos reconhecem a utilidade do conteúdo do Programa de Treino em Suporte Básico de Vida Pediátrico na sua prática quotidiana e a adequação dos seus conteúdos.
- Treino de competências em Suporte Básico de Vida Pediátrico: um programa em implementaçãoPublication . Prior, F; Costa, M; Monteiro, F; Henriques, P; Carneiro, R
- Treino de competências em reanimação pediátrica: narrativa de uma experiênciaPublication . Prior, F; Monteiro, F; Costa, M; Carneiro, R
- Prevalence and Predictive Factors of Exclusive Breastfeeding in the First Six Months of LifePublication . Branco, J; Manuel, AR; Completo, S; Marques, J; Rodrigues Antão, R; Pinto Gago, C; Paulino, E; Voutsen, O; Barroso, R
- Extracorporeal Membrane Oxygenation in an Adolescent with Multisystem Inflammatory Syndrome in ChildrenPublication . Gago, C; Lorenzo, C; Pinto, S; R. Sousa, A; Camilo, C; Abecasis, FMultisystem inflammatory syndrome in children is a rare and potentially life-threatening disease that is associated with SARS-CoV-2 infection, character-ized by hyperinflammation and multiorgan involvement. Cardiovascular involvement is common, including myocardial dysfunction often leading to cardio-genic shock. We present the case of a 17-year-old boy with fever, odynophagia, maculopapular rash and abdominal pain who developed a cardiogenic shock. Due to progressive deterioration of cardiac function despite optimized vasoactive support, veno-arterial extracorporeal membrane oxygenation support was initiated 12 hours after admission, with successful decannulation after seven days and discharge after 23 days, with normal cardiac function. The patient received corticosteroids and intravenous immunoglobulin. Early recognition and intensive care support are crucial for ensuring a successful outcome in severe cases of multisystem inflammatory syndrome. In cases of severe cardiogenic shock, extracorporeal membrane oxygenation support can be critical for survival and rapid recovery.
- COVID-19: Impact of the Pandemic on Children’s LivesPublication . Roquette, M; Jonet, J; Pires, J; Paes-Vasconcellos, AIntroduction: The COVID-19 pandemic has had a considerable impact on the biopsychosocial elements of human beings, especially children and teenagers, as vulnerable groups. Social isolation can lead to psychiatric illness, obesity, and sleep disorders in adults. This study aimed to determine the impact of lockdown on children’s sleep, diet, physical activity, and behavior. Methods: This was a retrospective observational study conducted from May 1, 2020, to March 31, 2021. Data were collected from four healthcare centers in Cascais (Lisbon, Portugal) by administering a questionnaire in person and online. Descriptive statistical analysis was conducted using Microsoft Excel® and the SPSS® software (version 23). Results: In total, 790 responses were collected (median age 9 years old) without gender predominance. Family routine and behavioral changes were found in 84% and 63% of children, respectively. In addition, dietary changes were observed in 43% of them, with 62% reporting an increase in quantities and 23% reporting weight gain (more than 5 kg in 18%). Regarding physical activity, 44% exercised more than three times a week before the lockdown. Following COVID-19, 18% maintained this routine, and 48% quit sporting activities. Finally, sleep changes occurred in 42%, including nightmares and difficulty falling asleep. Discussion: Childhood and adolescence are periods of considerable social and psychomotor development, and any routine disruption can cause profound changes in personal and interpersonal experience during this period. The findings of this study revealed that lockdown caused changes in children’s behavior, diet, physical exercise, and sleep. It is essential to outline strategies to support children and teenagers with a multidisciplinary approach to reduce the effects of social isolation on their development.
- Bronchopulmonary Dysplasia: A Five-Year Retrospective Cohort Study on Differences in Clinical Characteristics and Morbidities According to Severity GradingPublication . Kakoo Brioso, E; Moscoso, J; Malveiro, D; Aguiar, M; Tuna, MIntroduction: Bronchopulmonary dysplasia (BPD) is the most common complication associated with extreme prematurity. Although several criteria defining severity were developed over time, there are a few studies describing the differences in BPD phenotype and neonatal morbidities and complications between severity groups. We aimed to describe these differences in BPD patients of a neonatal intensive care unit (NICU). Methods: We conducted an observational retrospective cohort study through a medical record review over a five-year period. Participants were newborns admitted to an NICU who were diagnosed with BPD. We performed a descriptive statistical analysis of gestational complications and the use of antenatal corticosteroid therapy, birth-related data, and complications throughout the NICU stay, as well as the respiratory support used. We also compared different severity groups across these variables. The patients were divided into severe and non-severe BPD using the severity criteria of the 2001 NICHD/NHLBI/ORD consensus workshop. Results: A total of 101 newborns with BPD participated in the study and 73 had data on BPD severity. The median gestational age was 27 weeks, ranging from 23 to 32 weeks. Of these 73 newborns, 36 had mild BPD (49.3%), 10 had moderate BPD (13.7%), and 27 had severe BPD (37.0%). When comparing severe and non-severe BPD, we found that extreme prematurity, extremely low birth weight, and small size for gestational age were more frequent in the severe BPD group (p-value=0.012, p-value<0.001, and p-value=0.012, respectively). Infants with severe BPD had a longer duration of invasive ventilation than those with mild or moderate BPD (p-value<0.001). Late sepsis, necrotizing enterocolitis, severe brain injury, and retinopathy of prematurity were more frequent in severe BPD (p-value=0.017, p-value=0.045, p-value=0.033, p-value=0.003, respectively). Discussion: Previously published evidence describing causal links between BPD development and comorbidities exists but data on their impact on BPD severity are scarce. In our study, severe BPD seemed to be associated with a higher frequency of comorbidities and complications. Further studies are needed to ascertain the impact of each morbidity on the severity of BPD and if measures to prevent them could lead to potentially milder BPD disease.
- Ir para casa em segurança: teste de apneia do recém-nascido no sistema de retençãoPublication . Costa, M; Prior, F; Carneiro, R