Excesso de peso e sepse em pacientes cr?ticos pedi?tricos
Ano de defesa: | 2022 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Pontif?cia Universidade Cat?lica do Rio Grande do Sul
|
Programa de Pós-Graduação: |
Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a
|
Departamento: |
Escola de Medicina
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | https://tede2.pucrs.br/tede2/handle/tede/10424 |
Resumo: | Introduction: Childhood obesity is a serious public health problem. Little is known about the impact of this condition in critically ill pediatric patients. Sepsis is one of the major causes of admission and mortality of children in Pediatric Intensive Care Units (PICU), and few studies relate nutritional status with unfavorable outcomes in this condition. Objective: To determine the impact of excess weight on the outcomes of patients diagnosed with sepsis admitted to a PICU. Methods: Retrospective cohort study. Patients aged between 1 month and 18 years who were admitted to the PICU of a university hospital between 2013 and 2017 and who had a diagnosis of sepsis were included. The classification of nutritional status was performed using the Body Mass Index for Age. The severity at admission was assessed using the Pediatric Index of Mortality 2 (PIM 2) and the presence of a Complex Chronic Condition was observed. The outcomes analyzed were: mortality, length of stay in the PICU and hospital, need and days free of mechanical ventilation, Multiple Organ Dysfunction Syndrome and need and time of use of vasoactive and inotropic drugs. Inflammatory markers ferritin, c-reactive protein and leukocytes were also measured. Results: 456 subjects were included in the study. Regarding nutritional status, 385 individuals were eutrophic (84.4%) and 42 were overweight (9.2%). Obesity represented 6.4% of the sample (29 patients, 24 obese and 5 severely obese). As for the outcomes, an independent association between obesity and the need for NIV was found (RR=3.30 - CI 1.64 ? 6.65). Conclusion: An independent association between the presence of obesity and a greater need for NIV was found in critically ill pediatric patients with sepsis. |
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Garcia, Pedro Celiny Ramoshttp://lattes.cnpq.br/0761993714239641http://lattes.cnpq.br/0914103049069398Lopes, J?ssica Blatt2022-09-06T11:42:15Z2022-02-24https://tede2.pucrs.br/tede2/handle/tede/10424Introduction: Childhood obesity is a serious public health problem. Little is known about the impact of this condition in critically ill pediatric patients. Sepsis is one of the major causes of admission and mortality of children in Pediatric Intensive Care Units (PICU), and few studies relate nutritional status with unfavorable outcomes in this condition. Objective: To determine the impact of excess weight on the outcomes of patients diagnosed with sepsis admitted to a PICU. Methods: Retrospective cohort study. Patients aged between 1 month and 18 years who were admitted to the PICU of a university hospital between 2013 and 2017 and who had a diagnosis of sepsis were included. The classification of nutritional status was performed using the Body Mass Index for Age. The severity at admission was assessed using the Pediatric Index of Mortality 2 (PIM 2) and the presence of a Complex Chronic Condition was observed. The outcomes analyzed were: mortality, length of stay in the PICU and hospital, need and days free of mechanical ventilation, Multiple Organ Dysfunction Syndrome and need and time of use of vasoactive and inotropic drugs. Inflammatory markers ferritin, c-reactive protein and leukocytes were also measured. Results: 456 subjects were included in the study. Regarding nutritional status, 385 individuals were eutrophic (84.4%) and 42 were overweight (9.2%). Obesity represented 6.4% of the sample (29 patients, 24 obese and 5 severely obese). As for the outcomes, an independent association between obesity and the need for NIV was found (RR=3.30 - CI 1.64 ? 6.65). Conclusion: An independent association between the presence of obesity and a greater need for NIV was found in critically ill pediatric patients with sepsis.Introdu??o: A obesidade infantil ? um grave problema de sa?de p?blica. Pouco ainda se sabe sobre o impacto desta condi??o em pacientes cr?ticos pedi?tricos. A sepse ? uma das maiores causas de admiss?o e mortalidade de crian?as em Unidades de Terapia Intensiva Pedi?trica (UTIP), e poucos estudos relacionam o estado nutricional com desfechos desfavor?veis nesta condi??o. Objetivo: Determinar o impacto do excesso de peso nos desfechos de pacientes com diagn?stico de sepse, internados em uma UTIP. Metodologia: Estudo de coorte retrospectivo. Foram inclu?dos pacientes com idade entre 1 m?s e 18 anos, que internaram na UTIP de um hospital universit?rio, entre 2013 e 2017 e que tiveram diagn?stico de sepse em qualquer momento da interna??o. A classifica??o do estado nutricional foi realizada atrav?s do ?ndice de Massa Corporal para a Idade. A gravidade na admiss?o foi avaliada atrav?s do Pediatric Index of Mortality 2 (PIM 2) e a presen?a de Condi??o Cr?nica Complexa foi observada. Os desfechos analisados foram: mortalidade, tempo de interna??o em UTIP e hospitalar, necessidade e dias livres de ventila??o mec?nica, S?ndrome de Disfun??o de M?ltiplos ?rg?os e necessidade e tempo de uso de drogas vasoativas e inotr?picas. Tamb?m foram dosados os marcadores inflamat?rios ferritina, prote?na c-reativa e leuc?citos. Resultados: Foram inclu?dos 456 indiv?duos no estudo. Quanto ao estado nutricional, 385 indiv?duos apresentaram eutrofia (84,4%) e 42 apresentaram sobrepeso (9,2%). A obesidade representou 6,4% da amostra (29 pacientes, sendo 24 obesos e 5 obesos graves). Quanto aos desfechos, foi encontrada associa??o independente da obesidade com necessidade de uso de VNI (RR=3,30 - IC 1,64 ? 6,65). Conclus?o: Foi encontrada associa??o independente da presen?a de obesidade com maior necessidade de uso de VNI em pacientes cr?ticos pedi?tricos com sepse.Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2022-08-29T20:20:45Z No. of bitstreams: 1 Disserta??o J?ssica Blatt Lopes - CORRIGIDA AP?S BANCA.pdf: 1592828 bytes, checksum: 729e6dca445cf20fbfe44880d3edc91d (MD5)Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2022-09-06T11:39:01Z (GMT) No. of bitstreams: 1 Disserta??o J?ssica Blatt Lopes - CORRIGIDA AP?S BANCA.pdf: 1592828 bytes, checksum: 729e6dca445cf20fbfe44880d3edc91d (MD5)Made available in DSpace on 2022-09-06T11:42:15Z (GMT). No. of bitstreams: 1 Disserta??o J?ssica Blatt Lopes - CORRIGIDA AP?S BANCA.pdf: 1592828 bytes, checksum: 729e6dca445cf20fbfe44880d3edc91d (MD5) Previous issue date: 2022-02-24Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPESapplication/pdfhttps://tede2.pucrs.br/tede2/retrieve/185289/DIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdf.jpgporPontif?cia Universidade Cat?lica do Rio Grande do SulPrograma de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?aPUCRSBrasilEscola de MedicinaObesidadeObesidade InfantilSepseUnidades de Terapia Intensiva Pedi?tricaProgn?sticoObesityChild ObesitySepsisPediatric Intensive Care UnitsPrognosisCIENCIAS DA SAUDE::MEDICINAMEDICINA::SAUDE MATERNO-INFANTILCLINICA MEDICA::PEDIATRIAExcesso de peso e sepse em pacientes cr?ticos pedi?tricosinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisTrabalho ser? publicado como artigo ou livro60 meses06/09/2027557290555552975733500500500600600600-224747486637135387-969369452308786627-8067417953925345752-70271217037790659553590462550136975366info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILDIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdf.jpgDIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdf.jpgimage/jpeg4125https://tede2.pucrs.br/tede2/bitstream/tede/10424/4/DIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdf.jpg2250f59c7ec4274e39a34baf8e546f44MD54TEXTDIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdf.txtDIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdf.txttext/plain1686https://tede2.pucrs.br/tede2/bitstream/tede/10424/3/DIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdf.txtf47c171cc2691dea7bec38ce2607b9cfMD53ORIGINALDIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdfDIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdfapplication/pdf338573https://tede2.pucrs.br/tede2/bitstream/tede/10424/2/DIS_JESSICA_BLATT_LOPES_CONFIDENCIAL.pdfe9aaf8b6b1b0f78318afdb6342fdfee8MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8590https://tede2.pucrs.br/tede2/bitstream/tede/10424/1/license.txt220e11f2d3ba5354f917c7035aadef24MD51tede/104242022-09-06 12:00:16.806oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2022-09-06T15:00:16Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Excesso de peso e sepse em pacientes cr?ticos pedi?tricos |
title |
Excesso de peso e sepse em pacientes cr?ticos pedi?tricos |
spellingShingle |
Excesso de peso e sepse em pacientes cr?ticos pedi?tricos Lopes, J?ssica Blatt Obesidade Obesidade Infantil Sepse Unidades de Terapia Intensiva Pedi?trica Progn?stico Obesity Child Obesity Sepsis Pediatric Intensive Care Units Prognosis CIENCIAS DA SAUDE::MEDICINA MEDICINA::SAUDE MATERNO-INFANTIL CLINICA MEDICA::PEDIATRIA |
title_short |
Excesso de peso e sepse em pacientes cr?ticos pedi?tricos |
title_full |
Excesso de peso e sepse em pacientes cr?ticos pedi?tricos |
title_fullStr |
Excesso de peso e sepse em pacientes cr?ticos pedi?tricos |
title_full_unstemmed |
Excesso de peso e sepse em pacientes cr?ticos pedi?tricos |
title_sort |
Excesso de peso e sepse em pacientes cr?ticos pedi?tricos |
author |
Lopes, J?ssica Blatt |
author_facet |
Lopes, J?ssica Blatt |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Garcia, Pedro Celiny Ramos |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/0761993714239641 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0914103049069398 |
dc.contributor.author.fl_str_mv |
Lopes, J?ssica Blatt |
contributor_str_mv |
Garcia, Pedro Celiny Ramos |
dc.subject.por.fl_str_mv |
Obesidade Obesidade Infantil Sepse Unidades de Terapia Intensiva Pedi?trica Progn?stico |
topic |
Obesidade Obesidade Infantil Sepse Unidades de Terapia Intensiva Pedi?trica Progn?stico Obesity Child Obesity Sepsis Pediatric Intensive Care Units Prognosis CIENCIAS DA SAUDE::MEDICINA MEDICINA::SAUDE MATERNO-INFANTIL CLINICA MEDICA::PEDIATRIA |
dc.subject.eng.fl_str_mv |
Obesity Child Obesity Sepsis Pediatric Intensive Care Units Prognosis |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA MEDICINA::SAUDE MATERNO-INFANTIL CLINICA MEDICA::PEDIATRIA |
description |
Introduction: Childhood obesity is a serious public health problem. Little is known about the impact of this condition in critically ill pediatric patients. Sepsis is one of the major causes of admission and mortality of children in Pediatric Intensive Care Units (PICU), and few studies relate nutritional status with unfavorable outcomes in this condition. Objective: To determine the impact of excess weight on the outcomes of patients diagnosed with sepsis admitted to a PICU. Methods: Retrospective cohort study. Patients aged between 1 month and 18 years who were admitted to the PICU of a university hospital between 2013 and 2017 and who had a diagnosis of sepsis were included. The classification of nutritional status was performed using the Body Mass Index for Age. The severity at admission was assessed using the Pediatric Index of Mortality 2 (PIM 2) and the presence of a Complex Chronic Condition was observed. The outcomes analyzed were: mortality, length of stay in the PICU and hospital, need and days free of mechanical ventilation, Multiple Organ Dysfunction Syndrome and need and time of use of vasoactive and inotropic drugs. Inflammatory markers ferritin, c-reactive protein and leukocytes were also measured. Results: 456 subjects were included in the study. Regarding nutritional status, 385 individuals were eutrophic (84.4%) and 42 were overweight (9.2%). Obesity represented 6.4% of the sample (29 patients, 24 obese and 5 severely obese). As for the outcomes, an independent association between obesity and the need for NIV was found (RR=3.30 - CI 1.64 ? 6.65). Conclusion: An independent association between the presence of obesity and a greater need for NIV was found in critically ill pediatric patients with sepsis. |
publishDate |
2022 |
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2022-09-06T11:42:15Z |
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2022-02-24 |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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