DANIELA CARLA DE SOUZA
Projetos de Pesquisa
Unidades Organizacionais
PAINT-62, Hospital Universitário
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Operationalizing Appropriate Sepsis Definitions in Children Worldwide: Considerations for the Pediatric Sepsis Definition Taskforce(2023) CARROL, Enitan D.; RANJIT, Suchitra; MENON, Kusum D.; BENNETT, Tellen D.; SANCHEZ-PINTO, L. Nelson J.; ZIMMERMAN, Jerry J. C.; SOUZA, Daniela C. R.; SORCE, Lauren R. G.; RANDOLPH, Adrienne G.; ISHIMINE, Paul; OLIVEIRA, Claudio Flauzino de; LODHA, Rakesh; HARMON, Lori; WATSON, R. Scott J.; SCHLAPBACH, Luregn J.; KISSOON, Niranjan C.; ARGENT, Andrew C.Sepsis is a leading cause of global mortality in children, yet definitions for pediatric sepsis are outdated and lack global applicability and validity. In adults, the Sepsis-3 Definition Taskforce queried databases from high-income countries to develop and validate the criteria. The merit of this definition has been widely acknowledged; however, important considerations about less-resourced and more diverse settings pose challenges to its use globally. To improve applicability and relevance globally, the Pediatric Sepsis Definition Taskforce sought to develop a conceptual framework and rationale of the critical aspects and context-specific factors that must be considered for the optimal operationalization of future pediatric sepsis definitions. It is important to address challenges in developing a set of pediatric sepsis criteria which capture manifestations of illnesses with vastly different etiologies and underlying mechanisms. Ideal criteria need to be unambiguous, and capable of adapting to the different contexts in which children with suspected infections are present around the globe. Additionally, criteria need to facilitate early recognition and timely escalation of treatment to prevent progression and limit life-threatening organ dysfunction. To address these challenges, locally adaptable solutions are required, which permit individualized care based on available resources and the pretest probability of sepsis. This should facilitate affordable diagnostics which support risk stratification and prediction of likely treatment responses, and solutions for locally relevant outcome measures. For this purpose, global collaborative databases need to be established, using minimum variable datasets from routinely collected data. In summary, a ""Think globally, act locally"" approach is required.
- Reporting of Social Determinants of Health in Pediatric Sepsis Studies*(2023) MENON, Kusum R.; SORCE, Lauren; ARGENT, Andrew D.; BENNETT, Tellen D.; CARROL, Enitan; KISSOON, Niranjan; SANCHEZ-PINTO, L. Nelson J.; SCHLAPBACH, Luregn C.; SOUZA, Daniela de; WATSON, R. Scott L.; WYNN, James J.; ZIMMERMAN, Jerry; RANJIT, Suchitra; Pediat Sepsis Definition TaskforceOBJECTIVE:Standardized, consistent reporting of social determinants of health (SDOH) in studies on children with sepsis would allow for: 1) understanding the association of SDOH with illness severity and outcomes, 2) comparing populations and extrapolating study results, and 3) identification of potentially modifiable socioeconomic factors for policy makers. We, therefore, sought to determine how frequently data on SDOH were reported, which factors were collected and how these factors were defined in studies of sepsis in children. DATA SOURCES AND SELECTION:We reviewed 106 articles (published between 2005 and 2020) utilized in a recent systematic review on physiologic criteria for pediatric sepsis. DATA EXTRACTION:Data were extracted by two reviewers on variables that fell within the World Health Organization's SDOH categories. DATA SYNTHESIS:SDOH were not the primary outcome in any of the included studies. Seventeen percent of articles (18/106) did not report on any SDOH, and a further 36.8% (39/106) only reported on gender/sex. Of the remaining 46.2% of articles, the most reported SDOH categories were preadmission nutritional status (35.8%, 38/106) and race/ethnicity (18.9%, 20/106). However, no two studies used the same definition of the variables reported within each of these categories. Six studies reported on socioeconomic status (3.8%, 6/106), including two from upper-middle-income and four from lower middle-income countries. Only three studies reported on parental education levels (2.8%, 3/106). No study reported on parental job security or structural conflict. CONCLUSIONS:We found overall low reporting of SDOH and marked variability in categorizations and definitions of SDOH variables. Consistent and standardized reporting of SDOH in pediatric sepsis studies is needed to understand the role these factors play in the development and severity of sepsis, to compare and extrapolate study results between settings and to implement policies aimed at improving socioeconomic conditions related to sepsis.