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4.
Einstein (Sao Paulo) ; 18: eAO5476, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33053018

RESUMO

OBJECTIVE: To propose a predictive model for the length of stay risk among children admitted to a pediatric intensive care unit based on demographic and clinical characteristics upon admission. METHODS: This was a retrospective cohort study conducted at a private and general hospital located in the municipality of Sao Paulo, Brazil. We used internal validation procedures and obtained an area under ROC curve for the to build of the predictive model. RESULTS: The mean hospital stay was 2 days. Predictive model resulted in a score that enabled the segmentation of hospital stay from 1 to 2 days, 3 to 4 days, and more than 4 days. The accuracy model from 3 to 4 days was 0.71 and model greater than 4 days was 0.69. The accuracy found for 3 to 4 days (65%) and greater than 4 days (66%) of hospital stay showed a chance of correctness, which was considering modest. Conclusion: Our results showed that low accuracy found in the predictive model did not enable the model to be exclusively adopted for decision-making or discharge planning. Predictive models of length of stay risk that consider variables of patients obtained only upon admission are limit, because they do not consider other characteristics present during hospitalization such as possible complications and adverse events, features that could impact negatively the accuracy of the proposed model.


Assuntos
Unidades de Terapia Intensiva Pediátrica , Tempo de Internação/estatística & dados numéricos , Brasil , Criança , Hospitalização , Humanos , Valor Preditivo dos Testes , Estudos Retrospectivos
5.
Crit Care Med ; 48(11): 1553-1555, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33045150

RESUMO

OBJECTIVES: To describe the unique perspective of pediatric intensivists caring for critically ill adults during the coronavirus disease 2019 pandemic. DESIGN: Observational study. SETTING: Academic medical center in New York City. PATIENTS: Coronavirus disease 2019 positive adults requiring admission to an ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In late March 2020, New York Presbyterian Hospital centralized all of its inpatient pediatric units (n = 4) from across the network to a single center, in order to create space to accommodate the increasing number of critically ill adults with coronavirus disease 2019. Within 1 week, the PICU at New York Presbyterian Hospital-Weill Cornell Medicine transferred or discharged all inpatients, underwent a transformation of the physical space, and began admitting adults of all ages with coronavirus disease 2019 related acute respiratory failure. The New York Presbyterian Hospital-Weill Cornell Medicine PICU physician group continued to lead this unit. PICU nurses, respiratory therapists, social workers, and child life specialists joined their PICU physician colleagues to care for these critically ill adults. CONCLUSIONS: In the coronavirus disease 2019 pandemic, PICU physicians are well poised to care for adult patients in a surge capacity, and bring a unique perspective to the experience.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Cuidados Críticos/organização & administração , Estado Terminal/terapia , Unidades de Terapia Intensiva Pediátrica/organização & administração , Pneumonia Viral/terapia , Centros de Atenção Terciária/organização & administração , Adulto , Infecções por Coronavirus/epidemiologia , Estado Terminal/epidemiologia , Feminino , Humanos , Masculino , Cidade de Nova Iorque , Pandemias , Pneumonia Viral/epidemiologia , Índice de Gravidade de Doença
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1031-1034, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018161

RESUMO

Blood infection due to different circumstances could immediately develop to an extreme body reaction that leads to a serious life-threatening condition, called Sepsis. Currently, therapeutic protocols through timely antibiotic resuscitation strategies play an important role to fight against the adverse conditions and improve survival. Therefore, timing, and more specifically early diagnosis of the illness, is crucially important for an effective treatment. Studies have indicated that vital signals such as heart rate variability (HRV) could provide potential prognostic biological markers that can help with early detection of sepsis before it is clinically diagnosed through its actual symptoms. Therefore, this study employs neonatal and pediatric electrocardiogram (ECG) to extract 52 hourly sets of linear and non-linear features from the HRV, starting from 24 hours prior to the clinical diagnosis of sepsis in patients with positive blood cultures (n=14). Similar sets of features were also obtained from a non-sepsis control group to create an evaluation benchmark (n=14).In particular, this study initially demonstrates how the variations within the 24 hours values of specific HRV feature-sets could effectively reveal prognostic information about the evolution of sepsis, prior to the actual clinical diagnosis. Moreover, this study demonstrates that differences in the values of a particular set of features at 22 hours before the actual clinical diagnosis/symptoms can be reliably used to train a convolutional neural network for automatic classification between the individuals in the sepsis and non-sepsis groups with 88.89±7.86% accuracy.


Assuntos
Redes Neurais de Computação , Sepse , Criança , Diagnóstico Precoce , Frequência Cardíaca , Humanos , Unidades de Terapia Intensiva Pediátrica , Prognóstico , Sepse/diagnóstico
7.
J Indian Soc Pedod Prev Dent ; 38(3): 289-292, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33004728

RESUMO

Objective: In this coronavirus disease 2019 pandemic, pediatric children who are admitted in the intensive care unit (ICU) are more susceptible to ventilator-associated pneumonia. Ventilator-associated pneumonia is the second-most common hospital-acquired infection in pediatric ICU. Oral hygiene maintenance is a challenge here. To maintain oral hygiene and to prevent colonization of microorganisms such as Pseudomonas aeruginosa and Staphylococcus aureus which cause ventilator-associated pneumonia, a study was conducted, which aimed at finding the efficacy of chlorhexidine (CHX) wipes (as an oral hygiene aid) on colonization of these organisms in pediatric ICU. Methods and Methodology: The study was conducted among twenty children (8 in ventilation and 12 without ventilation) in the age range of 6-14 years admitted in the pediatric ICU. Swab sample was taken on the 1st day from both groups. Culturing of swab sample was done for colonization of microorganisms. CHX gluconate with a concentration of 0.2% was used as wipes. Swab sample was collected at the end of the 2nd day. Culturing of swab sample was done for colonization of microorganisms. Statistical analysis was done. Results: A statistically significant difference (P ≤ 0.04) was seen in the ventilator group with a mean of 0.75 ± 13.241 in the reduction of S. aureus count. P. aeruginosa growth was not seen in either of the groups before or after the use of CHX wipe. Conclusions: Standard oral hygiene practice has the potential to contribute to improved oral and general health of children in pediatric ICU. CHX wipes significantly reduced S. aureus count in ventilator patients. Hence, it could be used as an effective antimicrobial agent in pediatric ICU.


Assuntos
Clorexidina , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Staphylococcus aureus , Adolescente , Betacoronavirus , Criança , Humanos , Unidades de Terapia Intensiva Pediátrica , Pseudomonas aeruginosa
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5627-5630, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019253

RESUMO

Blood infection due to different circumstances could immediately develop to an extreme body reaction that leads to a serious life-threatening condition, called Sepsis. Currently, therapeutic protocols through timely antibiotic resuscitation strategies play an important role to fight against the adverse conditions and improve survival. Therefore, timing, and more specifically early diagnosis of the illness, is crucially important for an effective treatment. Studies have indicated that vital signals such as heart rate variability (HRV) could provide potential prognostic biological markers that can help with early detection of sepsis before it is clinically diagnosed through its actual symptoms. Therefore, this study employs neonatal and pediatric electrocardiogram (ECG) to extract 52 hourly sets of linear and non-linear features from the HRV, starting from 24 hours prior to the clinical diagnosis of sepsis in patients with positive blood cultures (n=14). Similar sets of features were also obtained from a non-sepsis control group to create an evaluation benchmark (n=14).In particular, this study initially demonstrates how the variations within the 24 hours values of specific HRV featuresets could effectively reveal prognostic information about the evolution of sepsis, prior to the actual clinical diagnosis. Moreover, this study demonstrates that differences in the values of a particular set of features at 22 hours before the actual clinical diagnosis/symptoms can be reliably used to train a convolutional neural network for automatic classification between the individuals in the sepsis and non-sepsis groups with 88.89±7.86% accuracy.Clinical relevance- Results suggest potential early diagnosis of sepsis through real-time automatic classification of HRV features as prognostic indicators in clinical ECG recordings.


Assuntos
Redes Neurais de Computação , Sepse , Criança , Diagnóstico Precoce , Frequência Cardíaca , Humanos , Unidades de Terapia Intensiva Pediátrica , Prognóstico , Sepse/diagnóstico
10.
Acta Biomed ; 91(11-S): e2020004, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-33004774

RESUMO

Italy is one of the most exposed countries worldwide to COVID-19, and Lombardy is the most affected region in Italy. In this context, Fondazione IRCCS Policlinico San Matteo in Pavia, one of the largest University hospitals in the region, has been involved in the management of the outbreak since its inception. Immediately after the communication of the first Italian COVID-19+ patient, the Pediatric Unit has been completely reorganized to face the approaching outbreak. The optimization of the Pediatric Unit resources for COVID-19 emergency is reported as an example to safely preserve health activity during the pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Serviço Hospitalar de Emergência/organização & administração , Unidades de Terapia Intensiva Pediátrica/organização & administração , Pneumonia Viral/epidemiologia , Criança , Infecções por Coronavirus/terapia , Humanos , Itália/epidemiologia , Pandemias , Pneumonia Viral/terapia
12.
Cochrane Database Syst Rev ; 10: CD013101, 2020 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-33045104

RESUMO

BACKGROUND: Corticosteroids are routinely given to children undergoing cardiac surgery with cardiopulmonary bypass (CPB) in an attempt to ameliorate the inflammatory response. Their use is still controversial and the decision to administer the intervention can vary by centre and/or by individual doctors within that centre. OBJECTIVES: This review is designed to assess the benefits and harms of prophylactic corticosteroids in children between birth and 18 years of age undergoing cardiac surgery with CPB. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and Conference Proceedings Citation Index-Science in June 2020. We also searched four clinical trials registers and conducted backward and forward citation searching of relevant articles. SELECTION CRITERIA: We included studies of prophylactic administration of corticosteroids, including single and multiple doses, and all types of corticosteroids administered via any route and at any time-point in the perioperative period. We excluded studies if steroids were administered therapeutically. We included individually randomised controlled trials (RCTs), with two or more groups (e.g. multi-drug or dose comparisons with a control group) but not 'head-to-head' trials without a placebo or a group that did not receive corticosteroids. We included studies in children, from birth up to 18 years of age, including preterm infants, undergoing cardiac surgery with the use of CPB. We also excluded studies in patients undergoing heart or lung transplantation, or both; studies in patients already receiving corticosteroids; in patients with abnormalities of the hypothalamic-pituitary-adrenal axis; and in patients given steroids at the time of cardiac surgery for indications other than cardiac surgery. DATA COLLECTION AND ANALYSIS: We used the Covidence systematic review manager to extract and manage data for the review. Two review authors independently assessed studies for inclusion, extracted data, and assessed risks of bias. We resolved disagreements by consensus or by consultation with a third review author. We assessed the certainty of evidence with GRADE. MAIN RESULTS: We found 3748 studies, of which 888 were duplicate records. Two studies had the same clinical trial registration number, but reported different populations and interventions. We therefore included them as separate studies. We screened titles and abstracts of 2868 records and reviewed full text reports for 84 studies to determine eligibility. We extracted data for 13 studies. Pooled analyses are based on eight studies. We reported the remaining five studies narratively due to zero events for both intervention and placebo in the outcomes of interest. Therefore, the final meta-analysis included eight studies with a combined population of 478 participants. There was a low or unclear risk of bias across the domains. There was moderate certainty of evidence that corticosteroids do not change the risk of in-hospital mortality (five RCTs; 313 participants; risk ratio (RR) 0.83, 95% confidence interval (CI) 0.33 to 2.07) for children undergoing cardiac surgery with CPB. There was high certainty of evidence that corticosteroids reduce the duration of mechanical ventilation (six RCTs; 421 participants; mean difference (MD) 11.37 hours lower, 95% CI -20.29 to -2.45) after the surgery. There was high-certainty evidence that the intervention probably made little to no difference to the length of postoperative intensive care unit (ICU) stay (six RCTs; 421 participants; MD 0.28 days lower, 95% CI -0.79 to 0.24) and moderate-certainty evidence that the intervention probably made little to no difference to the length of the postoperative hospital stay (one RCT; 176 participants; mean length of stay 22 days; MD -0.70 days, 95% CI -2.62 to 1.22). There was moderate certainty of evidence for no effect of the intervention on all-cause mortality at the longest follow-up (five RCTs; 313 participants; RR 0.83, 95% CI 0.33 to 2.07) or cardiovascular mortality at the longest follow-up (three RCTs; 109 participants; RR 0.40, 95% CI 0.07 to 2.46). There was low certainty of evidence that corticosteroids probably make little to no difference to children separating from CPB (one RCT; 40 participants; RR 0.20, 95% CI 0.01 to 3.92). We were unable to report information regarding adverse events of the intervention due to the heterogeneity of reporting of outcomes. We downgraded the certainty of evidence for several reasons, including imprecision due to small sample sizes, a single study providing data for an individual outcome, the inclusion of both appreciable benefit and harm in the confidence interval, and publication bias. AUTHORS' CONCLUSIONS: Corticosteroids  probably do not change the risk of mortality for children having heart surgery using CPB at any time point. They probably reduce the duration of postoperative ventilation in this context, but have little or no effect on the total length of postoperative ICU stay or total postoperative hospital stay. There was inconsistency in the adverse event outcomes reported which, consequently, could not be pooled. It is therefore impossible to provide any implications and policy-makers will be unable to make any recommendations for practice without evidence about adverse effects. The review highlighted the need for well-conducted RCTs powered for clinical outcomes to confirm or refute the effect of corticosteroids versus placebo in children having cardiac surgery with CPB. A core outcome set for adverse event reporting in the paediatric major surgery and intensive care setting is required.


Assuntos
Corticosteroides/uso terapêutico , Procedimentos Cirúrgicos Cardíacos/métodos , Ponte Cardiopulmonar/efeitos adversos , Inflamação/prevenção & controle , Adolescente , Corticosteroides/efeitos adversos , Viés , Procedimentos Cirúrgicos Cardíacos/mortalidade , Ponte Cardiopulmonar/mortalidade , Causas de Morte , Criança , Pré-Escolar , Dexametasona/uso terapêutico , Máquina Coração-Pulmão/efeitos adversos , Mortalidade Hospitalar , Humanos , Hidrocortisona/uso terapêutico , Lactente , Recém-Nascido , Inflamação/etiologia , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Tempo de Internação , Metilprednisolona/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Respiração Artificial/estatística & dados numéricos
14.
Adv Clin Exp Med ; 29(9): 1117-1121, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32937040

RESUMO

BACKGROUND: Patients treated in neonatal/pediatric intensive care units (N/PICUs) are frequently exposed to pain. To assess its severity, several behavioral and behavioral-physiological scales are used, but their usefulness is limited. It is therefore justified to search for additional methods to assess the adequacy of analgesia and sedation in these patients. OBJECTIVES: To evaluate the usefulness of skin conductance (SC) measurement in the assessment of analgosedation quality in infants requiring mechanical ventilation treated in N/PICUs. MATERIAL AND METHODS: Thirty infants aged 6-208 days treated in 6 N/PICUs, mechanically ventilated and receiving analgosedation, were included for the study. Simultaneous COMFORT-B assessment and SC measurement using SCA (skin conductance algesimeter) monitor were performed. Due to technical problems, not all of the SC records could be interpreted, and finally 412 simultaneous assessments on the COMFORT-B scale and SC measurements in 29 patients were analyzed. RESULTS: We found a statistically significant correlation between the COMFORT-B scoring and the SC measurements. Additionally, SC was significantly lower when the behavioral score indicated deep sedation, in comparison to periods when it indicated moderate or insufficient analgosedation. CONCLUSIONS: Skin conductance measurements are comparable with the COMFORT-B rating in mechanically ventilated infants receiving analgosedation. The SCA monitor may be of value in the assessment of analgosedation quality, and in particular may identify the situation where sedation is deep. Further research is needed regarding the suitability of this device in clinical practice.


Assuntos
Respiração Artificial , Analgesia , Criança , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Pediátrica , Dor , Projetos Piloto
15.
Medicine (Baltimore) ; 99(36): e22075, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899077

RESUMO

Red blood cell distribution width (RDW) is a component of routine complete blood count, which reflects variability in the size of circulating erythrocytes. Recently, there have been many reports about RDW as a strong prognostic marker in various disease conditions in the adult population. However, only a few studies have been performed in children. This study aimed to investigate the association between RDW and pediatric intensive care unit (PICU) mortality in critically ill children. This study includes 960 patients admitted to the PICU from November 2012 to May 2018. We evaluated the associations between RDW and clinical parameters including PICU mortality outcomes. The median age of the study population was 15.5 (interquartile range, 4.8-54.5) months. The mean RDW was 15.6% ±â€Š3.3%. The overall PICU mortality was 8.8%. As we categorized patients into 3 groups with respect to RDW values (Group 1: ≤14.5%; Group 2: 14.5%-16.5%; and Group 3: >16.5%) and compared clinical parameters, the higher RDW groups (Groups 2 and 3) showed more use of vasoactive-inotropic drugs, mechanical ventilator support, higher severity scores, including pediatric risk of mortality III, pediatric sequential organ failure assessment, pediatric logistic organ dysfunction-2 (PELOD-2), and pediatric multiple organ dysfunction syndrome scores, and higher PICU mortality than the lower RDW group (Group 1) (P < .05). Based on multivariate logistic regression analysis adjusted for age and sex, higher RDW value (≥14.5%) was an independent risk factor of PICU mortality. Moreover, adding RDW improved the performance of the PELOD-2 score in predicting PICU mortality (category-free net reclassification index 0.357, 95% confidence interval 0.153-0.562, P = .001). In conclusion, higher RDW value was significantly associated with worse clinical parameters including PICU mortality. RDW was an independent risk factor of PICU mortality and the addition of RDW significantly improved the performance of PELOD-2 score in predicting PICU mortality. Thus, RDW could be a promising prognostic factor with advantages of simple and easy measurement in critically ill pediatric patients.


Assuntos
Estado Terminal/mortalidade , Mortalidade Hospitalar/tendências , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Fatores Etários , Biomarcadores , Pré-Escolar , Índices de Eritrócitos , Feminino , Humanos , Lactente , Masculino , Insuficiência de Múltiplos Órgãos/mortalidade , Escores de Disfunção Orgânica , Prognóstico , Estudos Prospectivos , Curva ROC , República da Coreia/epidemiologia , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais
16.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32917845

RESUMO

OBJECTIVES: To explore and define contemporary trends in the use of invasive mechanical ventilation (IMV) and noninvasive ventilation (NIV) in the treatment of children with asthma. METHODS: We performed a serial cross-sectional analysis using data from the Pediatric Health Information System. We examined 2014-2018 admission abstracts from patients aged 2 to 17 years who were admitted to member hospitals with a primary diagnosis of asthma. We report temporal trends in IMV use, NIV use, ICU admission, length of stay, and mortality. RESULTS: Over the study period, 48 hospitals reported 95 204 admissions with a primary diagnosis of asthma. Overall, IMV use remained stable at 0.6% between 2014 and 2018 (interquartile range [IQR]: 0.3%-1.1% and 0.2%-1.3%, respectively), whereas NIV use increased from 1.5% (IQR: 0.3%-3.2%) to 2.1% (IQR: 0.3%-5.6%). There was considerable practice variation among centers, with NIV rates more than doubling within the highest quartile of users (from 4.8% [IQR: 2.8%-7.5%] to 13.2% [IQR: 7.4%-15.2%]; P < .02). ICU admission was more common among centers with high NIV use, but centers with high NIV use did not differ from lower-use centers in mortality, IMV use, or overall average length of stay. CONCLUSIONS: The use of IMV is at historic lows, and NIV has replaced it as the primary mechanical support mode for asthma. However, there is considerable variability in NIV use. Increased NIV use was not associated with a change in IMV rates, which remained stable. Higher NIV use was associated with increased ICU admissions. NIV's precise contribution to the cost and quality of care remains to be determined.


Assuntos
Asma/terapia , Ventilação não Invasiva/tendências , Respiração Artificial/tendências , Adolescente , Asma/mortalidade , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Unidades de Terapia Intensiva Pediátrica/tendências , Tempo de Internação/tendências , Masculino , Fatores de Tempo
17.
Crit Care ; 24(1): 536, 2020 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867803

RESUMO

BACKGROUND: In critically ill children, omitting early use of parenteral nutrition (late-PN versus early-PN) reduced infections, accelerated weaning from mechanical ventilation, and shortened PICU stay. We hypothesized that fasting-induced ketogenesis mediates these benefits. METHODS: In a secondary analysis of the PEPaNIC RCT (N = 1440), the impact of late-PN versus early-PN on plasma 3-hydroxybutyrate (3HB), and on blood glucose, plasma insulin, and glucagon as key ketogenesis regulators, was determined for 96 matched patients staying ≥ 5 days in PICU, and the day of maximal 3HB-effect, if any, was identified. Subsequently, in the total study population, plasma 3HB and late-PN-affected ketogenesis regulators were measured on that average day of maximal 3HB effect. Multivariable Cox proportional hazard and logistic regression analyses were performed adjusting for randomization and baseline risk factors. Whether any potential mediator role for 3HB was direct or indirect was assessed by further adjusting for ketogenesis regulators. RESULTS: In the matched cohort (n = 96), late-PN versus early-PN increased plasma 3HB throughout PICU days 1-5 (P < 0.0001), maximally on PICU day 2. Also, blood glucose (P < 0.001) and plasma insulin (P < 0.0001), but not glucagon, were affected. In the total cohort (n = 1142 with available plasma), late-PN increased plasma 3HB on PICU day 2 (day 1 for shorter stayers) from (median [IQR]) 0.04 [0.04-0.04] mmol/L to 0.75 [0.04-2.03] mmol/L (P < 0.0001). The 3HB effect of late-PN statistically explained its impact on weaning from mechanical ventilation (P = 0.0002) and on time to live PICU discharge (P = 0.004). Further adjustment for regulators of ketogenesis did not alter these findings. CONCLUSION: Withholding early-PN in critically ill children significantly increased plasma 3HB, a direct effect that statistically mediated an important part of its outcome benefit.


Assuntos
Corpos Cetônicos/biossíntese , Nutrição Parenteral , Suspensão de Tratamento , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Masculino , Resultado do Tratamento
19.
Balkan Med J ; 37(6): 341-347, 2020 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-32865382

RESUMO

Aims: Limited data about disease management strategies are available for pediatric patients with coronavirus disease-2019, particularly in Turkey. This study aimed to share the data on patients aged under 18 years in our country to be beneficial for understanding the disease course in children. Methods: A retrospective review of the medical records of pediatric patients aged under 18 years who were confirmed as coronavirus disease-2019 between March 11, and June 23, 2020, and were admitted to our hospitals was conducted. Results: A total of 220 pediatric patients with coronavirus disease-2019 were evaluated, of which 48.2% were boys, with a median age of 10 years, and 9.5% had underlying diseases. Patients were classified according to severity, with the percentages of asymptomatic, mild, moderate, and critical/severe cases determined to be 25.5%, 45%, 26.8%, and 2.7%, respectively. Extracorporeal membrane oxygenation was required in two patients (0.9%) and mechanical ventilation in three (1.4%). Targeted therapies were used in six patients (2.7%), with hydroxychloroquine being the most commonly used agent either alone (one patient) or in combination with favipiravir (five patients). Two patients (0.9%) died, and nine (4.1%) were still hospitalized during the study period. Conclusion: Although the disease course of coronavirus disease-2019 seems to be mild in children, critical illness is significant, and the treatment strategy primarily should consist of supportive care according to our preliminary observations.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Gravidade do Paciente , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Adolescente , Amidas/uso terapêutico , Antimaláricos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Criança , Pré-Escolar , Infecções por Coronavirus/diagnóstico , Oxigenação por Membrana Extracorpórea , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Pediátrica , Tempo de Internação , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Pirazinas/uso terapêutico , Respiração Artificial , Estudos Retrospectivos , Resultado do Tratamento , Turquia
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