CINTIA JOHNSTON
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
2 resultados
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Agora exibindo 1 - 2 de 2
- Electrical impedance tomography clues to detect pulmonary thrombosis in a teenager with COVID-19(2022) FORONDA, Flavia Andrea Krepel; FERNANDES, Leonardo Rocha; LAHOZ, Ana Lucia Capelari; JOHNSTON, Cintia; CARVALHO, Werther Brunow deWe report a case of pulmonary thrombosis in a teenager during a hypercoagulable state associated with COVID-19 (coronavirus disease 2019) caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). A condition rare in children and adolescents, pulmonary thrombosis underdiagnosis likely increases morbidity and mortality. A pulmonary thrombosis diagnosis requires a high level of suspicion and relies on the combination of clinical presentation, D-dimer elevation, and computed tomography (CT) pulmonary angiography or ventilation/perfusion scans, imaging techniques that are difficult to perform. Electrical impedance tomography (EIT) has gained attention, as it provides real-time ventilation distribution analysis. In addition, lung pulsatility images can be obtained through this technique using electrocardiogram gating to filter out ventilation. In this case report, the reduced EIT pulsatility corresponded to the perfusion defect found on the CT scan, information that was obtained at the bedside without radiation or contrast exposure.
- Early Mobilization in PICU: Are We on Time?(2019) JOHNSTON, C.; KREBS, V.L.J.; CARVALHO, W.B. de; CARNEIRO-SAMPAIO, M.Purpose of review: Elements based on specific literature to assist in the elaboration of an early mobilization (EM) protocol for severely ill children in a pediatric intensive care unit or in an inpatient care unit. Recent findings: Recent findings have shown that immobility during critical periods of the disease may cause physical, neuromusculoskeletal, metabolic, cognitive, and psychological sequelae that may extend throughout life. Prolonged bed rest is associated with thromboembolic events, decreased protein synthesis and muscle mass, and increased risk of death. Children surviving from serious illnesses have an increased risk of delay in overall recovery, resulting in poor quality of life and increased costs of post-discharge health services in the short, medium, and long term. Summary: Further research is needed to delineate protocols for specific populations in PICU as well as to find associations between interventions in PICU with EM, and with outcome times spent in PICU and hospital, need for care after hospital discharge, death and quality of life, among others. © 2019, Springer Nature Switzerland AG.