LILIAN DOS SANTOS RODRIGUES SADECK
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
15 resultados
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- Translating Neonatal Resuscitation Guidelines Into Practice in Brazil(2022) ALMEIDA, Maria Fernanda B. de; GUINSBURG, Ruth; WEINER, Gary M.; PENIDO, Marcia G.; FERREIRA, Daniela M. L. M.; ALVES, Jose Mariano S.; EMBRIZI, Lais F.; GIMENES, Carolina B.; SILVA, Nathalia M. Mello E.; FERRARI, Ligia L.; VENZON, Paulyne S.; GOMEZ, Dafne B.; VALE, Marynea S. do; BENTLIN, Maria Regina; SADECK, Lilian R.; DINIZ, Edna M. A.; FIORI, Humberto H.; CALDAS, Jamil P. S.; ALMEIDA, Joao Henrique C. L. de; DUARTE, Jose Luis M. B.; GONCALVES-FERRI, Walusa A.; PROCIANOY, Renato S.; LOPES, Jose Maria A.BACKGROUND AND OBJECTIVES: The Brazilian Neonatal Resuscitation Program releases guidelines based on local interpretation of international consensus on science and treatment recommendations. We aimed to analyze whether guidelines for preterm newborns were applied to practice in the 20 Brazilian Network on Neonatal Research centers of this middle-income country. METHODS: Prospectively collected data from 2014 to 2020 were analyzed for 8514 infants born at 23(0/7) to 31(6/7) weeks' gestation. The frequency of procedures was evaluated by gestational age (GA) category, including use of a thermal care bundle, positive pressure ventilation (PPV), PPV with a T-piece resuscitator, maximum fraction of inspired oxygen (Fio(2)) concentration during PPV, tracheal intubation, chest compressions and medications, and use of continuous positive airway pressure in the delivery room. Logistic regression, adjusted by center and year, was used to estimate the probability of receiving recommended treatment. RESULTS: For 3644 infants 23 to 27 weeks' GA and 4870 infants 28 to 31 weeks' GA, respectively, the probability of receiving care consistent with guidelines per year increased, including thermal care (odds ratio [OR], 1.52 [95% confidence interval (CI) 1.44-1.61] and 1.45 [1.38-1.52]) and PPV with a T-piece (OR, 1.45 [95% CI 1.37-1.55] and 1.41 [1.32-1.51]). The probability of receiving PPV with Fio(2) 1.00 decreased equally in both GA groups (OR, 0.89; 95% CI, 0.86-0.93). CONCLUSIONS: Between 2014 and 2020, the resuscitation guidelines for newborns <32 weeks' GA on thermal care, PPV with a T-piece resuscitator, and decreased use of Fio(2) 1.00 were translated into clinical practice.
bookPart Integração do cuidado perinatal: do modelo em rede de atenção à saúde materno-fetal aos microprocessos nas unidades perinatais(2022) REGO, Maria Albertina Santiago; BARROS, Marina Carvalho de Moraes; MACHRY, Joana S.; GOMES, Maria Auxiliadora de Souza Mendes; GALERA, Marcial Francis; ALMEIDA, João Henrique Carvalho Leme de; SADECK, Lilian dos Santos Rodrigues- Fatores de risco associados ao desmame em crianças até seis meses de idade no município de São Paulo(2012) LEONE, Cléa Rodrigues; SADECK, Lilian dos Santos R.OBJECTIVE: To evaluate risk factors associated to interruption of exclusive breastfeeding among children <6 months of age in São Paulo city in 2008. METHODS: A special questionnaire (Breastfeeding and Cities Project-1998) was applied to the parents/guardians of children <6 months of age during the National Poliomyelitis Campaign. Sample calculation used a two stage cluster sampling procedure. The following groups were compared: I (children exclusively breastfed); II (children without exclusive breastfeeding). Factors analyzed: mother's age and schooling, infant birth weight, gender, type of delivery, being born in a Baby-Friendly Hospital, presence of early breastfeeding, use of pacifier in the last 24 hours, and mother working outside home. Statistical analysis included binary logistic regression by SPSS 15.0, being significant p<0.05. RESULTS: 724 interviews were performed with 275 (39.1%) children in Group I and 429 (60.9%) in Group II. Differences between groups were found on: use of pacifier in the last 24 hours (GI 32.3 vs. GII59.8%; p<0.0001), mothers working outside home (GI 12.4 vs. GII 24.8%; p=0.0002) and child's age(GI 74.1±45.3 vs. GII105.8±49.5 days; p<0.0001). Multivariate analysis showed significant association of non-exclusive breastfeeding in this sample with use of pacifier in the last 24 hours (OR 3.02; 95%CI 2.10-4.36); mother working outside home (OR 2.11; 95%CI 1.24-3.57), and child's age (OR 1.01, 95%CI 1.01-1.02). CONCLUSIONS: In this population under six months of age, the use of pacifier in the last 24 hours was associated with not being exclusively breastfed, as well as mother work outside home and child's age. These are important factors to consider in breastfeeding promotion programs.
bookPart Integração do cuidado hospitalar ao ambulatorial(2022) REGO, Maria Albertina Santiago; NADER, Silvana Salgado; VALE, Marynea Silva do; SADECK, Lilian dos Santos Rodrigues; SILVEIRA, Rita de Cássia dos Santos; GRAZIANO, Rosa MariabookPart Interação cardiorrespiratória: conceitos fisiológicos para monitoramento e estratégias do cuidado na prematuridade(2022) LYRA, João César; RUGOLO, Ligia Maria Suppo de Souza; SADECK, Lilian dos Santos RodriguesbookPart Diagnóstico diferencial das insuficiências respiratórias do recém-nascido(2019) SADECK, Lilian dos Santos RodriguesbookPart Abordagem clínica das principais malformações congênitas(2022) BOY, Raquel; GIBELLI, Maria Augusta Bento Cicaroni; AFIUNE, Jorge Yussef; ALMEIDA, João Henrique Carvalho Leme de; SADECK, Lilian dos Santos Rodrigues; PIçARRO, CléciobookPart Reanimação neonatal do recém-nascido a termo e pré-termo(2022) MELO, Ana Maria Andréllo Gonçalves Pereira de; SADECK, Lílian dos Santos Rodrigues- Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists(2012) GUINSBURG, R.; ALMEIDA, M. F. Branco de; SADECK, L. dos Santos Rodrigues; MARBA, S. T. M.; RUGOLO, L. M. Suppo de Souza; LUZ, J. H.; LOPES, J. M. de Andrade; MARTINEZ, F. E.; PROCIANOY, R. S.Objective: To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death. Study Design: Prospective cohort of 484 infants with 23(0/7) to 26(6/7) weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of >= 1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life. Result: Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions. Conclusion: In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day. Journal of Perinatology (2012) 32, 913-919; doi:10.1038/jp.2012.28; published online 29 March 2012
bookPart Diagnóstico diferencial de desconforto respiratório em recém-nascidos(2022) ZACHARIAS, Romy Schmidt Brock; SADECK, Lílian dos Santos Rodrigues