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Priscilla de Oliveira Cavalheiro

Bio: Priscilla de Oliveira Cavalheiro is an academic researcher. The author has an hindex of 1, co-authored 1 publications receiving 28 citations.

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Journal ArticleDOI
TL;DR: The Berlin definition can identify a subgroup of patients with distinctly worse outcomes, as shown by the increased mortality and reduced number of ventilator-free days in pediatric patients with severe acute respiratory distress syndrome.
Abstract: Objectives:In 2012, a new acute respiratory distress syndrome definition was proposed for adult patients. It was later validated for infants and toddlers. Our objective was to evaluate the prevalence, outcomes, and risk factors associated with acute respiratory distress syndrome in children up to 15

34 citations


Cited by
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TL;DR: This Position Paper provides the first consensus definition for neonatal ARDS (called the Montreux definition), and provides expert consensus that mechanisms causing ARDS in adults and older children-namely complex surfactant dysfunction, lung tissue inflammation, loss of lung volume, increased shunt, and diffuse alveolar damage-are also present in several critical neonatal respiratory disorders.

178 citations

Journal ArticleDOI
TL;DR: Although advances of ventilator strategies in the management of ARDS associated with outcome improvements-such as protective mechanical ventilation, lower driving pressure, higher PEEP levels and prone positioning-ARDS appears to be undertreated and mortality remains elevated up to 40%.
Abstract: Fifty years ago, Ashbaugh and colleagues defined for the first time the acute respiratory distress syndrome (ARDS), one among the most challenging clinical condition of the critical care medicine. The scientific community worked over the years to generate a unified definition of ARDS, which saw its revisited version in the Berlin definition, in 2014. Epidemiologic information about ARDS is limited in the era of the new Berlin definition, and wide differences are reported among countries all over the world. Despite decades of study in the field of lung injury, ARDS is still so far under-recognized, with 2 out of 5 cases missed by clinicians. Furthermore, although advances of ventilator strategies in the management of ARDS associated with outcome improvements—such as protective mechanical ventilation, lower driving pressure, higher PEEP levels and prone positioning—ARDS appears to be undertreated and mortality remains elevated up to 40%. In this review, we cover the history that led to the current worldwide accepted Berlin definition of ARDS and we summarize the recent data regarding ARDS epidemiology.

139 citations

Journal ArticleDOI
TL;DR: The pooled mortality in pediatric ARDS was 24% and studies conducted and published later were associated with better survival, suggesting earlier year of publication was an independent factor associated with mortality.
Abstract: Objective:Sparse and conflicting evidence exists regarding mortality risk from pediatric acute respiratory distress syndrome (ARDS). We aimed to determine the pooled mortality in pediatric ARDS and to describe its trend over time.Data Sources and Study Selection:MEDLINE, EMBASE, and Web of Science were searched from 1960 to August 2015. Keywords or medical subject headings (MESH) terms used included “respiratory distress syndrome, adult,” “acute lung injury,” “acute respiratory insufficiency,” “acute hypoxemic respiratory failure,” “pediatrics,” and “child.” Study inclusion criteria were (1) pediatric patients aged 0 days to 18 years, (2) sufficient baseline data described in the pediatric ARDS group, and (3) mortality data. Randomized controlled trials (RCTs) and prospective observational studies were eligible.Data Extraction and Synthesis:Data on study characteristics, patient demographics, measures of oxygenation, and mortality were extracted using a standard data extraction form. Independent authors c...

80 citations

Journal ArticleDOI
TL;DR: The field of global critical care, barriers to safe high-quality care, and potential solutions to existing challenges are reviewed and a roadmap for improving the treatment of critically ill patients in resource-limited settings is suggested.
Abstract: Caring for critically ill patients is challenging in resource-limited settings, where the burden of disease and mortality from potentially treatable illnesses is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings include lack of epidemiologic data and context-specific evidence for medical decision-making, deficiencies in health systems organization and resources, and institutional obstacles to implementation of life-saving interventions. Potential solutions include the development of common definitions for intensive care unit (ICU), intensivist, and intensive care to create a universal ICU organization framework; development of educational programs for capacity building of health care professionals working in resource-limited settings; global prioritization of epidemiologic and clinical research in resource-limited settings to conduct timely and ethical studies in response to emerging threats; adaptation of international guidelines to promote implementation of evidence-based care; and strengthening of health systems that integrates these interventions. This manuscript reviews the field of global critical care, barriers to safe high-quality care, and potential solutions to existing challenges. We also suggest a roadmap for improving the treatment of critically ill patients in resource-limited settings.

60 citations

Journal ArticleDOI
TL;DR: This review outlines what is known about ARDS secondary to viral infections including the epidemiology, the pathophysiology, and diagnosis, and emerging treatment options to prevent infection, and to decrease disease burden.
Abstract: Viral infections are an important cause of pediatric Acute Respiratory Distress Syndrome (ARDS). Numerous viruses, including respiratory syncytial virus (RSV) and influenza A (H1N1) virus, have been implicated in the progression of pneumonia to ARDS; yet the incidence of progression is unknown. Despite acute and chronic morbidity associated with respiratory viral infections, particularly in ‘at risk’ populations, treatment options are limited. Thus, with few exceptions, care is symptomatic. In addition, mortality rates for viral related ARDS have yet to be determined. This review outlines what is known about ARDS secondary to viral infections including the epidemiology, the pathophysiology and diagnosis. In addition, emerging treatment options to prevent infection, and to decrease disease burden will be outlined. We focused on RSV and influenza A (H1N1) viral-induced ARDS, as these are the most common viruses leading to pediatric ARDS, and have specific prophylactic and definitive treatment options.

37 citations