Clinical and Epidemiological Profiles of Patients Admitted to a Pediatric Cardiac Intensive Care Unit

Abstract

Background: Congenital and acquired heart diseases are important causes of morbidity and mortality in children. In critical congenital heart defects, when treatment is not adequate, clinical manifestations may lead to death in the neonatal period.Objective: To establish the clinical and epidemiological profile of patients admitted to the pediatric cardiac intensive care unit (UTI) in a tertiary hospital.Methods: This was a cross-sectional study conducted from January 2013 to December 2014, based on analysis of patients' medical records. The study sample was composed of 307 children and adolescents with congenial and acquired heart diseases. The score Risk Adjustement for Congenital Heart Surgery 1 (RACHS-1) was used for categorization of the various surgical procedures. Descriptive statistics were calculated using the Satistical Package for Social Sciences (SPSS). Categorical variables were compared using the Pearson's chi-square test, considering a level of significance of 5%.Results: There was a predominance of patients aged between 28 days and one year (44%). Congenital heart diseases (91.9%) prevailed over acquired heart diseases (8.1%). Extracorporeal circulation was used in 138 patients who underwent surgical procedures, lasting from 12 to 261 minutes. Most patients (88.9%) were discharged from the ICU and 11.1% died. Using the score RACHS-1, corrective cardiac surgery was performed in 75.8% and paliative surgery in 24.2% of the patients. Conclusions:Patients aged between 28 days to one year, with cyanotic congenital heart disease, undergoing cardiac surgery with extracorporeal circulation duration longer than 120 minutes are at a higher risk of death.

BNCC E O ENSINO DE LITERATURA: o trabalho nas trincheiras e frinchas para (quem sabe) abrir portões

“…Considerando que a BNCC é uma referência para a elaboração de currículos e que testes e exames como o ENEM "têm estruturado estratégias de conformação dos currículos do ensino secundário em Portugal e do Ensino Médio no Brasil (..)" (Guimarães;Morgado, 2016, p. 388), é inegável a força desse exame, que pode "definir" o futuro dos jovens estudantes. Da mesma forma, é flagrante que a maneira como a literatura é abordada no ENEM: "a literatura enquanto leitura [mais] do que a literatura enquanto aprendizagem cultural" (Luft, 2019, p. 144), o que tende a fragilizar a formação de leitores literários.…”

“…Se exames como o ENEM têm grande impacto na elaboração dos currículos (Guimarães;Morgado, 2016), por que não, pensando na valorização da leitura literária, incluir a literatura de forma orgânica (com a recomendação de obras) no ENEM e, por consequência, nos currículos? Ainda que a ideia, a princípio, possa parecer inconcebível, é bom nos lembrarmos de que nas escolas públicas contamos com as obras do Programa Nacional do Livro e do Material Didático (PNLD) 6 .…”

Risk Factors of Mortality in the Intensive Care Unit Following Cardiac Surgery for Congenital Heart Diseases in Children

“…Preoperative factors include age, sex, type of cardiac anomaly, concomitant non-cardiac disorders (pulmonary hypertension, renal dysfunction), and transfusion of blood products. Intraoperative factors involve intraoperative complications, cardiopulmonary bypass (CPB) time, and the need for an intra-aortic balloon pump, a ventricular assist device, extracorporeal membrane oxygenation, or red blood cell transfusion (2,3). Postoperative risk factors include the length of pediatric intensive care unit (PICU) or hospital stay, complications such as cardiac surgery-associated acute kidney injury (CS-AKI), nosocomial infections, septic shock, cardiogenic shock, and heart failure (4)(5)(6).…”