WERTHER BRUNOW DE CARVALHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
3 resultados
Resultados de Busca
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- Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2)(2023) EMERIAUD, Guillaume; LOPEZ-FERNANDEZ, Yolanda; IYER, Narayan Prabhu; BEMBEA, Melania M.; AGULNIK, Asya; BARBARO, Ryan P.; BAUDIN, Florent; BHALLA, Anoopindar; CARVALHO, Werther Brunow de; CARROLL, Christopher L.; CHEIFETZ, Ira M.; CHISTI, Mohammod J.; CRUCES, Pablo; CURLEY, Martha A. Q.; DAHMER, Mary K.; DALTON, Heidi J.; ERICKSON, Simon J.; ESSOURI, Sandrine; FERNANDEZ, Analia; FLORI, Heidi R.; GRUNWELL, Jocelyn R.; JOUVET, Philippe; KILLIEN, Elizabeth Y.; KNEYBER, Martin C. J.; KUDCHADKAR, Sapna R.; KORANG, Steven Kwasi; LEE, Jan Hau; MACRAE, Duncan J.; MADDUX, Aline; I, Vicent M. Alapont; MORROW, Brenda M.; NADKARNI, Vinay M.; NAPOLITANO, Natalie; NEWTH, Christopher J. L.; PONS-ODENA, Marti; QUASNEY, Michael W.; RAJAPREYAR, Prakadeshwari; RAMBAUD, Jerome; RANDOLPH, Adrienne G.; RIMENSBERGER, Peter; ROWAN, Courtney M.; SANCHEZ-PINTO, L. Nelson; SAPRU, Anil; SAUTHIER, Michael; SHEIN, Steve L.; SMITH, Lincoln S.; STEFFEN, Katerine; TAKEUCHI, Muneyuki; THOMAS, Neal J.; TSE, Sze Man; VALENTINE, Stacey; WARD, Shan; WATSON, R. Scott; YEHYA, Nadir; ZIMMERMAN, Jerry J.; KHEMANI, Robinder G.OBJECTIVES:We sought to update our 2015 work in the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) guidelines for the diagnosis and management of pediatric acute respiratory distress syndrome (PARDS), considering new evidence and topic areas that were not previously addressed. DESIGN:International consensus conference series involving 52 multidisciplinary international content experts in PARDS and four methodology experts from 15 countries, using consensus conference methodology, and implementation science. SETTING:Not applicable. PATIENTS:Patients with or at risk for PARDS. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Eleven subgroups conducted systematic or scoping reviews addressing 11 topic areas: 1) definition, incidence, and epidemiology; 2) pathobiology, severity, and risk stratification; 3) ventilatory support; 4) pulmonary-specific ancillary treatment; 5) nonpulmonary treatment; 6) monitoring; 7) noninvasive respiratory support; 8) extracorporeal support; 9) morbidity and long-term outcomes; 10) clinical informatics and data science; and 11) resource-limited settings. The search included MEDLINE, EMBASE, and CINAHL Complete (EBSCOhost) and was updated in March 2022. Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to summarize evidence and develop the recommendations, which were discussed and voted on by all PALICC-2 experts. There were 146 recommendations and statements, including: 34 recommendations for clinical practice; 112 consensus-based statements with 18 on PARDS definition, 55 on good practice, seven on policy, and 32 on research. All recommendations and statements had agreement greater than 80%. CONCLUSIONS:PALICC-2 recommendations and consensus-based statements should facilitate the implementation and adherence to the best clinical practice in patients with PARDS. These results will also inform the development of future programs of research that are crucially needed to provide stronger evidence to guide the pediatric critical care teams managing these patients.
- Born into an isolating world: family-centred care for babies born to mothers with COVID-19(2023) DOWSE, G.; PERKINS, E. J.; STEIN, H. M.; CHIDINI, G.; DANHAIVE, O.; ELSAYE, Y. N.; CARVALHO, W. B.; ALNAQEEB, N.; ROOZE, S.; CETINKAYA, M.; VETTER-LARACY, S.; PILAR-ORIVE, F. J.; TORPIANO, P.; FERRI, W. A. Goncalves; BUONSENSO, D.; ROGDO, B.; MEDINA, A.; POLITO, A.; BROUWER, C. N. M.; KNEYBER, M. C. J.; LUCA, D. De; TINGAY, D. G.; REGISTRY, Espnic Covid-Paediatric Neonatal E. P. I. C. E. M. T. R. E.Background The benefits of facilitating breastmilk feeding and close contact between mother and neonate (family-centred care; FCC) in the perinatal period are well-established. The aim of this study was to determine how the delivery of FCC practices were impacted for neonates born to mothers with perinatal SARS-CoV-2 infection during the COVID-19 pandemic. Methods Neonates born to mothers with confirmed SARS-CoV-2 infection during pregnancy were identified from the 'EsPnIC Covid paEdiatric NeonaTal REgistry' (EPICENTRE) multinational cohort between 10 March 2020 and 20 October 2021. The EPICENTRE cohort collected prospective data on FCC practices. Rooming-in and breastmilk feeding practice were the main outcomes, and factors influencing each were determined. Other outcomes included mother-baby physical contact prior to separation and the pattern of FCC components relative to time and local site guidelines. Findings 692 mother-baby dyads (13 sites, 10 countries) were analysed. 27 (5%) neonates were positive for SARS-CoV-2 (14 (52%) asymptomatic). Most sites had policies that encouraged FCC during perinatal SARS-CoV-2 infection for most of the reporting period. 311 (46%) neonates roomed-in with their mother during the admission. Rooming-in increased over time from 23% in March-June 2020 to 74% in January-March 2021 (boreal season). 330 (93%) of the 369 separated neonates had no FCC physical contact with their mother prior, and 319 (86%) were asymptomatic. Maternal breastmilk was used for feeding in 354 (53%) neonates, increasing from 23% to 70% between March-June 2020 and January-March 2021. FCC was most impacted when mothers had symptomatic COVID-19 at birth. Interpretation This is the largest report of global FCC practice during the COVID-19 pandemic to date. The COVID-19 pandemic may have impacted FCC despite low perinatal transmission rates. Fortunately, clinicians appear to have adapted to allow more FCC delivery as the COVID-19 pandemic progressed.
- A Core Outcome Set for Pediatric Critical Care*(2020) FINK, Ericka L.; MADDUX, Aline B.; PINTO, Neethi; SORENSON, Samuel; NOTTERMAN, Daniel; DEAN, J. Michael; CARCILLO, Joseph A.; BERG, Robert A.; ZUPPA, Athena; POLLACK, Murray M.; MEERT, Kathleen L.; HALL, Mark W.; SAPRU, Anil; MCQUILLEN, Patrick S.; MOURANI, Peter M.; WESSEL, David; AMEY, Deborah; ARGENT, Andrew; CARVALHO, Werther Brunow de; BUTT, Warwick; CHOONG, Karen; CURLEY, Martha A. Q.; LOPEZ, Maria del Pilar Arias; DEMIRKOL, Demet; GROSSKREUZ, Ruth; HOUTROW, Amy J.; KNOESTER, Hennie; LEE, Jan Hau; LONG, Debbie; MANNING, Joseph C.; MORROW, Brenda; SANKAR, Jhuma; SLOMINE, Beth S.; SMITH, McKenna; OLSON, Lenora M.; WATSON, R. ScottObjectives: More children are surviving critical illness but are at risk of residual or new health conditions. An evidence-informed and stakeholder-recommended core outcome set is lacking for pediatric critical care outcomes. Our objective was to create a multinational, multistakeholder-recommended pediatric critical care core outcome set for inclusion in clinical and research programs. Design: A two-round modified Delphi electronic survey was conducted with 333 invited research, clinical, and family/advocate stakeholders. Stakeholders completing the first round were invited to participate in the second. Outcomes scoring greater than 69% ""critical"" and less than 15% ""not important"" advanced to round 2 with write-in outcomes considered. The Steering Committee held a virtual consensus conference to determine the final components. Setting: Multinational survey. Patients: Stakeholder participants from six continents representing clinicians, researchers, and family/advocates. Measurements and Main Results: Overall response rates were 75% and 82% for each round. Participants voted on seven Global Domains and 45 Specific Outcomes in round 1, and six Global Domains and 30 Specific Outcomes in round 2. Using overall (three stakeholder groups combined) results, consensus was defined as outcomes scoring greater than 90% ""critical"" and less than 15% ""not important"" and were included in the final PICU core outcome set: four Global Domains (Cognitive, Emotional, Physical, and Overall Health) and four Specific Outcomes (Child Health-Related Quality of Life, Pain, Survival, and Communication). Families (n = 21) suggested additional critically important outcomes that did not meet consensus, which were included in the PICU core outcome set-extended. Conclusions: The PICU core outcome set and PICU core outcome set-extended are multistakeholder-recommended resources for clinical and research programs that seek to improve outcomes for children with critical illness and their families.