Vivian Mara Mara Goncalves de Oliveira Azevedo
@ufu.br
Universidade Federal de Uberlândia
RESEARCH, TEACHING, or OTHER INTERESTS
Physical Therapy, Sports Therapy and Rehabilitation, Respiratory Care, Multidisciplinary, Pediatrics, Perinatology and Child Health
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Rejane Sousa Romão, Vivian Mara Gonçalves de Oliveira Azevedo, Rayany Cristina Souza, Eliziane Santos Medeiros, Priscilla Larissa Silva Pires, Leandro Alves Pereira, and Ana Elisa Madalena Rinaldi
Wiley
ABSTRACTIn Brazil, the Kangaroo Care Method (KCM) is a public policy that proposes systematic and humanized care for preterm low birth weight infants (LBWI), and one of its pillars is breastfeeding promotion. Therefore, this study aims to compare complementary feeding of LBWI in terms of age of introduction and the type of food offered according to the type of care received—KCM or Conventional Care (CC). A prospective cohort study was conducted from September 2019 to August 2021 at a Brazilian university hospital. A total of 65 LBWI born at the institution weighing 1800 g or less were included. Data were collected during the first week of hospitalization and at 4 and 6 months of corrected age. The median age at food introduction was estimated by survival analysis using the Kaplan–Meier method. The log‐rank test was used to compare the median age at the time of food introduction according to the type of care. Longer exclusive breastfeeding (KCM = 30 days; CC = 0.001, p = 0.002) and continued breastfeeding were observed in KCM preterm infants (KCM = 172 days; CC = 0.001, p = 0.002). The median age at introduction of infant formula (KCM = 38 days; CC = 35 days), water (KCM = 65 days; CC = 46 days), salted porridge (KCM = 139 days; CC = 136 days) and fruits (KCM = 134 days; CC = 136 days) was similar between both types of care received. No ultra‐processed foods were consumed. In conclusion, despite encouraging exclusive and continuous breastfeeding, there was no significant difference in the time of introduction of foods according to the type of care received.
Isadora A. Martins, Vivian M.G.O. Azevedo, Gabriela S.M.A. Pinheiro, Luiza A. Ford, Renata M.P. Silva, Leticia U. Rodrigues, Janaína M. Moreira, Stela M.A. Lemos, and Claudia R.L. Alves
Elsevier BV
Priscilla Larissa Silva Pires, Rejane Sousa Romão, Rayany Cristina de Souza, Leandro Alves Pereira, A. E. M. Rinaldi and V. M. Azevedo
O objetivo deste artigo foi analisar a associação entre os fatores sociodemográficos, as características maternas e neonatais e o tempo de introdução da alimentação complementar em recém-nascidos pré-termo e com baixo peso. Trata-se de um estudo de coorte prospectivo feito com 79 recém-nascidos pré-termo com peso menor ou igual a 1.800g. Os dados foram coletados no momento da alta hospitalar e ao 6º, 9º e 12º mês de idade gestacional corrigida (IGC), com auxílio de um questionário estruturado para analisar o tempo de introdução da alimentação complementar e texturas dos alimentos introduzidos. Além disso, para avaliar o risco de atraso de desenvolvimento, utilizou-se o Survey of Well-being of Young Children (SWYC-BR). Para análise das variáveis, aplicou-se regressão de riscos proporcionais de Cox. A introdução da alimentação complementar foi observada nos recém-nascidos pré-termo, com a mediana de idade de introdução de alimentos líquidos (3,50; IQ: 2,50-5,00), seguido por sólidos (4,70; IQ: 3,20-5,20) e pastosos (5,00; IQ: 4,50-5.50). Ainda, verificou-se associação da idade gestacional (RR = 1.25; IC95%: 1,02-1,52) em todo o processo da introdução alimentar. Para os alimentos sólidos e pastosos, aqueles com o maior tempo de internação (RR = 1,03; IC95%: 1,10- 1,05) e em amamentação mista (RR = 2,97; IC95%: 1,24-7,09) adiaram mais o tempo para introduzir a alimentação complementar. Para alimentos líquidos, recém-nascidos pré-termo menos graves (Score for Neonatal Acute Physiology and Perinatal Extension - SNAPPE II [RR = 0,96; IC95%: 0,94-0,98]) e mães que estavam amamentando na alta hospitalar (RR = 11,49; IC95%: 1,57-84,10) postergaram a introdução alimentar. Diretrizes para melhor orientação de profissionais e pais e/ou responsáveis sobre o momento ideal de introdução alimentar se faz necessário.
Fernando Lamy-Filho, Marivanda Julia Furtado Goudard, Sérgio Tadeu Martins Marba, Alcione Miranda dos Santos, Geisy Maria de Souza Lima, Roberta Costa, Vivian Mara Gonçalves de Oliveira Azevedo, and Zeni Carvalho Lamy
FapUNIFESP (SciELO)
Abstract Objectives: to evaluate the association between the time to initiate the first skin-to-skin contact (SSC) and the daily practice time with the rates of late-onset sepsis in newborns ≤1,800g. Methods: a multicentric cohort study was carried out at the neonatal units located in three Brazilian geographic regions. The SSC time was recorded in individual files by the hospital staff and the newborn’s parents. Maternal and neonatal data were obtained from medical records and through questionnaires applied to the mothers. Data analysis was carried out using a tree algorithm classification, which divided the data set into mutually exclusive subsets that best described the variable response. Results: 405 newborns participated in the study, with an average of 31.3 ± 2.7 weeks and 1,412g (QR=1,164-1,605g) as a median birth weight. The first SSC was carried out within 137 hours of life (≤5.7 days) was associated with a lower rate of late sepsis (p=0.02) for newborns who underwent daily SSC of 112.5 to 174.7 min/day (1.9 to 2.9h/day), with a reduction in the sepsis rate from 39.3% to 27.5%. Furthermore, the duration of SSC >174.7min/day (>2.9h/day) was relevant (p<0.001) for newborns who weighed >1,344g, with a reduction in this rate from 24.1% to 6%. Conclusions: SSP has been proven to be significant in reducing late-onset sepsis rates in preterm newborns, especially when carried out in a timely manner (≤5.7 days) and prolonged (>2.9h/day).
Rejane Sousa Romão, Rayany Cristina Souza, Eliziane Santos Medeiros, Priscilla Larissa Silva Pires, Leandro Alves Pereira, Vivian Mara Gonçalves de Oliveira Azevedo, and Ana Elisa Madalena Rinaldi
Wiley
Objective:The objective of this study is to compare feeding practices of low birthweight (LBW) infants, according to type of care received during and after hospital discharge: Kangaroo Care (KC) and Conventional Care (CC).Methods:Prospective cohort study was conducted at a university hospital (Brazil) between 2019 and 2021. The sample consisted of 65 LBW infants (weight ≤ 1800 g)—46 in KC and 19 in CC. KC includes breastfeeding (BF) guidance and support to parents at hospital and after discharge. Data collection was performed at hospital discharge, and at the 4th and 6th month of corrected gestational age (CGA). Consumption of 27 foods was analyzed in the last 2 periods of the follow‐up and expressed in relative frequency. Three indicators were analyzed: exclusive breastfeeding (EBF), mixed BF, and introduction of liquid and solid foods.Results:Groups had similar health characteristics, except for the weight at hospital discharge and the Score for Neonatal Acute Physiology – Perinatal (SNAPPE II) score that were lower in KC group. We found higher frequency of EBF among KC at hospital discharge (CC = 5.3% vs KC = 47.8%; P = 0.001). The higher frequency of mixed BF was observed in KC at 4 months of CGA (CC = 5.6% vs KC = 35.0%; P = 0.023), and at 6 months of CGA (CC = 0.0% vs KC = 24.4%; P = 0.048). Consumption of solid foods (4th month of CGA = 25.9%, 6th month of CGA = 91.2%) and liquids (4th month of CGA = 77.6%, 6th month of CGA = 89.5%) were similar between groups.Conclusions:In KC, SNAPPE II scores were lower and frequency of EBF was higher at hospital discharge and frequency of mixed BF was higher over 6 months. Early supply of infant formula, liquid and solid foods were similar in both groups.
Gabriela Soutto Mayor Assumpção Pinheiro, Rayany Cristina de Souza, Vivian Mara Gonçalves de Oliveira Azevedo, Nathalia Sernizon Guimarães, Laura Gregório Pires, Stela Maris Aguiar Lemos, and Claudia Regina Lindgren Alves
Springer Science and Business Media LLC
Gabriella Vieira Carneiro, Fabiana Sodré de Oliveira, Leandro Alves Pereira, Érica Rodrigues Mariano de Almeida Rezende, Luciana Carneiro Pereira Gonçalves, and Vivian Mara Gonçalves de Oliveira Azevedo
FapUNIFESP (SciELO)
Abstract Objective: To analyze the association between phenotypic and genotypic characteristics and disease severity in individuals with cystic fibrosis treated at a reference center in Minas Gerais, Brazil. Methods: This is a retrospective study that collected clinical and laboratory data, respiratory and gastrointestinal manifestations, type of treatment, Shwachman-Kulczycki score, and mutations from the patients’ medical records. Results: The sample included 50 participants aged one to 33 years, 50% of whom were female. Out of the one hundred alleles of the Cystic Fibrosis Transmembrane Conductance Regulator gene, the most prevalent mutations were DeltaF508 (45%) and S4X (18%). Mutation groups were only associated with pancreatic insufficiency (p=0.013) and not with disease severity (p=0.073). The latter presented an association with colonization by Pseudomonas aeruginosa and Staphylococcus aureus (p=0.007) and with underweight (p=0.036). Death was associated with age at diagnosis (p=0.016), respiratory symptomatology (p=0.013), colonization (p=0.024), underweight (p=0.017), and hospitalization (p=0.003). Conclusions: We could identify the association of mutations with pancreatic insufficiency; the association of Staphylococcus aureus colonization and underweight with disease severity; and the lack of association between mutations and disease severity. Environmental factors should be investigated more thoroughly since they seem to have an important effect on disease severity.
Bruna Schiphorst Delgado, Roberta Costa, Janaina Medeiros de Souza, Juliana Coelho Pina, Vívian Mara Gonçalves de Oliveira Azevedo, and Débora Evelin Felix Quirino de Almeida
Universidade de Estado do Rio de Janeiro
Objetivo: descrever como ocorre a prática do contato pele a pele em uma unidade neonatal referência para o Método Canguru. Método: estudo descritivo, transversal, realizado em unidade intensiva neonatal do sul do Brasil. Dados analisados por meio de estatística descritiva simples. Protocolo aprovado pelo Comitê de Ética em Pesquisa. Resultados: analisados dados de 29 recém-nascidos pré-termo, com peso menor de 1.800 gramas. O primeiro contato pele a pele foi realizado, em média, com 6,38 dias. A frequência de contato pele a pele foi de 1,6 vezes ao dia, sendo o tempo mínimo de 56 minutos e o ganho ponderal médio de 26,98 gramas por dia. Conclusão: a realização do contato pele a pele acontece, em sua maioria, após o quinto dia de vida, na primeira etapa do Método. A frequência de realização deste contato foi de uma vez por dia e o tempo de duração médio foi de 120 minutos. Na segunda etapa do Método, os dados pouco variaram.
Andressa Sabrina de Oliveira Resende, Suzi Laine Longo dos Santos Bacci, Ítalo Ribeiro Paula, Leandro Alves Pereira, Cíntia Johnston, Valéria Cabral Neves Luszczynski, and Vívian Mara Gonçalves de Oliveira Azevedo
Associação de Medicina Intensiva Brasileira
Objective To describe the role of physiotherapists in assisting patients suspected to have or diagnosed with COVID-19 hospitalized in intensive care units in Brazil regarding technical training, working time, care practice, labor conditions and remuneration. Methods An analytical cross-sectional survey was carried out through an electronic questionnaire distributed to physiotherapists who worked in the care of patients with COVID-19 in Brazilian intensive care units. Results A total of 657 questionnaires were completed by physiotherapists from the five regions of the country, with 85.3% working in adult, 5.4% in neonatal, 5.3% in pediatric and 3.8% in mixed intensive care units (pediatric and neonatal). In intensive care units with a physiotherapists available 24 hours/day, physiotherapists worked more frequently (90.6%) in the assembly, titration, and monitoring of noninvasive ventilation (p = 0.001). Most intensive care units with 12-hour/day physiotherapists (25.8%) did not apply any protocol compared to intensive care units with 18-hour/day physiotherapy (9.9%) versus 24 hours/day (10.2%) (p = 0.032). Most of the respondents (51.0%) received remuneration 2 or 3 times the minimum wage, and only 25.1% received an additional payment for working with patients suspected to have or diagnosed with COVID-19; 85.7% of them did not experience a lack of personal protective equipment. Conclusion Intensive care units with 24-hour/day physiotherapists had higher percentages of protocols and noninvasive ventilation for patients with COVID-19. The use of specific resources varied between the types of intensive care units and hospitals and in relation to the physiotherapists’ labor conditions. This study showed that most professionals had little experience in intensive care and low wages.
Marivanda Julia Furtado Goudard, Zeni Carvalho Lamy, Laize Nogueira de Caldas, Sérgio Tadeu Martins Marba, Roberta Costa, Geisy Maria Souza de Lima, Vivian Mara Gonçalves de Oliveira Azevedo, and Fernando Lamy
Acta Paulista de Enfermagem
possibilitem
Adna Nascimento Souza, Zeni Carvalho Lamy, Marivanda Julia Furtado Goudard, Sérgio Tadeu Martins Marba, Roberta Costa, Laize Nogueira de Caldas, Vivian Mara Gonçalves de Oliveira Azevedo, and Fernando Lamy-Filho
FapUNIFESP (SciELO)
Abstract This article aims to evaluate the factors associated with a skin-to-skin contact time <180 min/day in newborns weighing up to 1,800 g during neonatal hospitalization. Prospective observational cohort study conducted in neonatal units of reference for the Kangaroo Method in Brazil. Data from 405 dyads (mother/child) were analyzed from May 2018 to March 2020. Maternal and neonatal explanatory variables were collected from medical records and interviews. Skin-to-skin contact was recorded in forms posted at the bedside, filled out by parents and staff. The outcome variable was the mean time of skin-to-skin contact < 180 min/day. Hierarchical modeling was performed by Poisson regression with robust variance. The variables associated with the outcome were “without easy access to the hospital”, “without previous knowledge of the kangaroo method” and “having had morbidities during pregnancy”. Mothers without easy access to the hospital and who are unaware of the kangaroo method should be priority targets for health policies to develop strategies that promote greater exposure to skin-to-skin contact during the hospitalization period of their children.
Dannyele Nunes Carrijo, Marília Neves Santos, Vivian Mara Gonçalves de Oliveira Azevedo, and Ana Elisa Madalena Rinaldi
Elsevier BV
Rayany Cristina de Souza, Paula Carolina Bejo Wolkers, Leandro Alves Pereira, Rejane Sousa Romão, Eliziane Santos Medeiros, Daniela Marques de Lima Mota Ferreira, Ana Elisa Madalena Rinaldi, and Vivian Mara Gonçalves de Oliveira Azevedo
Elsevier BV
Vanessa A. D. S. Rodrigues, Yahn R. Abreu, Camila A. G. Santos, Alan F. Gatti, Gabriella M. Murer, Bárbara D. R. Gontijo, Juliana S. Alves, Thayna M. Cunha, Vivian Mara G. O. Azevedo, Tânia M. S. Mendonça,et al.
Wiley
AbstractBackgroundNonpharmacological labor pain management methods (NPLPMM) are noninvasive, low‐cost practices that may play a role in reducing the rates of unnecessary cesarean birth. We aimed to evaluate whether the NPLPMM is associated with the mode of birth.MethodsWe conducted a retrospective cohort study with clinical records of all women admitted for birth from January 2013 to December 2017. Records of women who had spontaneous labor or received induction or augmentation of labor during hospitalization were eligible for the study. We estimated the risk ratios for cesarean birth in general linear models using the Poisson regression with adjustments for the following variables: age, ethnicity, schooling, parity, gestational age, previous cesarean birth, spontaneous labor before admission, or induction/augmentation of labor.ResultsWithin the total of 3,391 medical records, 40.1% had the use of a nonpharmacological labor pain management method registered. Cesarean rate among the study population was 44.2%. The use of NPLPMM decreased the risk of cesarean birth by 78% (OR = 0.22; 95% CI 0.19‐0.26). History of a previous cesarean birth (RR = 2.63; 95% CI 2.35‐2.64), the lack of use of NPLPMM (RR = 2.46; 95% CI 2.22‐2.72), and primiparity (RR = 2.09; 95% CI 1.86‐2.34) were the strongest risk factors for cesarean birth in the cohort.DiscussionThe use of NPLPMM may be an effective strategy to reduce unnecessary cesarean birth. Further studies to identify the efficacy of each method may help health professionals to offer more appropriate methods at different stages of labor.
Marivanda J.F. Goudard, Zeni C. Lamy, Sérgio T.M. Marba, Milady C.V. Cavalcante, Alcione M. dos Santos, Vivian M.G.de O. Azevedo, Roberta Costa, Carolina N.M. Guimarães, and Fernando Lamy-Filho
Elsevier BV
Cynthia Ribeiro do Nascimento Nunes, Nathalia Faria de Freitas, Juliana Rodrigues Peixoto Arruda, Marcelle D'Ávila Diniz Bartholomeu, Gislene Cristina Valadares, Thalyta Magalhães Rodrigues, Vivian Mara Gonçalves de Oliveira Azevedo, and Maria Cândida Ferrarez Bouzada
Elsevier BV
Rafaelle Cristine Oliveira Cordeiro, Daniela Marques de Lima Mota Ferreira, Heloísio dos Reis, Vivian Mara Gonçalves de Oliveira Azevedo, Airan dos Santos Protázio, and Vânia Olivetti Steffen Abdallah
FapUNIFESP (SciELO)
ABSTRACT Objective: To assess the prevalence of hypothermia in the delivery room, at admission, and 2 to 3 hours after admission in the neonatal intensive care unit (NICU), factors associated and possible relationship with morbidity and mortality in preterm infants with very low birth weight (VLBW). Methods: Cross-sectional study with data collection based on a retrospective review of medical records and including infants born in 2016 and 2017, with birth weights <1500g, and gestational ages <34 weeks. Data about VLBW preterm infants, maternal data and temperature in the delivery room were analyzed. Hypothermia was considered when axillary temperature <36°C. For statistical analysis, the chi-square test or G test, canonical and Spearman correlation, and logistic regression were used. Results: 149 newborns (NB) were included in the study. The prevalence of hypothermia in delivery room, at admission to the NICU and 2 to 3 hours after admission was 25.8%, 41.5% and 40.2%, respectively. The temperature of NBs was directly proportional to gestational age (p<0.010), birth weight (p<0.010), and Apgar score (p<0.050). There was an inverse association with hypothermia in the delivery room and cesarean delivery (OR 0.25; p=0.016). Conclusions: Hypothermia was a prevalent problem in the studied population. The neonatal temperature was directly proportional to gestational age, birth weight and Apgar score. Hypothermia was associated with maternal factors, such as cesarean delivery. It is necessary to implement and improve strategies for its prevention.
Marivanda Julia Furtado Goudard, Zeni Carvalho Lamy, Sérgio Tadeu Martins Marba, Geisy Maria de Souza Lima, Alcione Miranda dos Santos, Marynea Silva do Vale, Talyta Garcia da Silva Ribeiro, Roberta Costa, Vivian Mara Gonçalves de Oliveira Azevedo, and Fernando Lamy-Filho
Universidade de São Paulo. Agência de Bibliotecas e Coleções Digitais
OBJETIVE To understand the role of exposure to skin-to-skin contact and its minimum duration in determining exclusive breastfeeding at hospital discharge in infants weighing up to 1,800g at birth. METHODS A multicenter cohort study was carried out in five Brazilian neonatal units. Infants weighing ≤ 1,800g at birth were eligible. Skin-to-skin contact time was recorded by the health care team and parents on an individual chart. Maternal and infant data was obtained from maternal questionnaires and medical records. The Classification Tree, a machine learning method, was used for data analysis; the tree growth algorithm, using statistical tests, partitions the dataset into mutually exclusive subsets that best describe the response variable and calculates appropriate cut-off points for continuous variables, thus generating an efficient explanatory model for the outcome under study. RESULTS A total of 388 infants participated in the study, with a median of 31.6 (IQR = 29–31.8) weeks of gestation age and birth weight of 1,429g (IQR = 1,202–1,610). The exclusive breastfeeding rate at discharge was 61.6%. For infant’s weighting between 1,125g and 1,655g, exposed to skin-to-skin contact was strongly associated with exclusive breastfeeding. Moreover, infants who made an average > 149.6 min/day of skin-to-skin contact had higher chances in this outcome (74% versus 46%). In this group, those who received a severity score (SNAPPE-II) equal to zero increased their chances of breastfeeding (83% versus 63%). CONCLUSION Skin-to-skin contact proved to be of great relevance in maintaining exclusive breastfeeding at hospital discharge for preterm infants weighing 1,125g–1,655g at birth, especially in those with lower severity scores.
Gabriela Soutto Mayor Assumpção Pinheiro, Vivian Mara Gonçalves de Oliveira Azevedo, Aline Almeida Bentes, Gabriela Cintra Januário, José Nélio Januário, Mila Lemos Cintra, Ana Beatriz Araújo de Souza, Laura Gregório Pires, Stela Maris Aguiar Lemos, and Claudia Regina Lindgren Alves
FapUNIFESP (SciELO)
This serological survey, conducted in five Brazilian municipalities, evaluated the use of dried blood spots (DBS), obtained from newborns and their mothers, to detect SARS-CoV-2 IgG antibodies. DBS were obtained from 4,803 neonates aged up to seven days and their mothers, both asymptomatic, at public health care clinics during newborn screening. DBS were processed by ELISA to detect IgG antibodies against SARS-CoV-2 nucleocapsid antigen. Mothers of seropositive neonates were interviewed about sociodemographic characteristics and clinical and laboratory antecedents. Non-satisfactory samples, dyads with incomplete data, and vaccinated mothers were excluded. Of the 1,917 DBS dyads samples analyzed, 14.7% of neonates showed IgG antibodies against SARS-CoV-2. Among seropositive neonates, 73.2% of their mothers were also seropositive. More than half of the mothers with seropositive neonates denied clinical or laboratory suspicion of COVID-19 during pregnancy. Suspicion occurred in the third trimester for 24.6% of the mothers. This study tested an innovative strategy to improve the understanding of COVID-19 antibody dynamics during pregnancy and suggests the feasibility of a universal serological survey in puerperal women and neonates.
Mariana Zucherato D’Arcadia, Adriano Alves Pereira, Iraides Moraes Oliveira, Lucas Boaventura de Matos, Camilla Zamfolini Hallal, Cristina Guimarães Arantes Araújo, Adriano de Oliveira Andrade, Selma Terezinha Milagre, and Vivian Mara Gonçalves de Oliveira Azevedo
Springer Science and Business Media LLC
Cynthia Ribeiro Nascimento Nunes, Vivian Mara Gonçalves Oliveira Azevedo, Nathalia Faria Freitas, Thalyta Magalhães Rodrigues, Patrícia Rodrigues Costa, Fernanda Lima Alves, Marina Oliveira Rabello, Igor Braga Vieira Baião Salgado, and Maria Cândida Ferrarez Bouzada
Elsevier BV
Camila Piqui Nascimento, Larissa Prado Maia, Patrícia Terra Alves, Aline Teodoro de Paula, Jair Pereira Cunha Junior, Vânia Olivetti Steffen Abdallah, Daniela Marques de Lima Mota Ferreira, Luiz Ricardo Goulart, and Vivian Mara Gonçalves de Oliveira Azevedo
Elsevier BV
Fernanda Nascimento Alves, Vivian Mara Gonçalves de Oliveira Azevedo, Magda Regina Silva Moura, Daniela Marques de Lima Mota Ferreira, Cristina Guimarães Arantes Araújo, Clesnan Mendes-Rodrigues, and Paula Carolina Bejo Wolkers
FapUNIFESP (SciELO)
Resumo Esta revisão integrativa da literatura teve como objetivo verificar se o Método Canguru, conforme instituído no Brasil, desde a primeira etapa até o acompanhamento ambulatorial, tem influência sobre o aleitamento materno. Foram incluídas pesquisas realizadas no Brasil, publicadas em periódicos nacionais e internacionais, nas principais bases de dados, em português, inglês ou espanhol, nos anos de 2000 a 2017, disponíveis na íntegra e com a temática relacionada com o objetivo deste estudo. Foram encontrados 1328 artigos sendo excluídos artigos não realizados no Brasil, artigos de revisão da literatura e de temáticas não relacionadas com o Método Canguru, sendo então selecionados 21 estudos. As pesquisas encontradas apontaram para uma influência positiva do Método Canguru sobre o aleitamento materno e estabelecimento de vínculo entre mãe-filho. No entanto, a terceira etapa ou acompanhamento ambulatorial, não se mostrou eficaz na manutenção do aleitamento materno. Faz-se necessário maior participação da atenção básica nos cuidados domiciliares prestados ao recém-nascido pré-termo, com vistas à promoção do aleitamento materno exclusivo até os seis meses de idade e complementado até os dois anos.
João Paulo Berti Buzzi Rodrigues, Suzi Laine Longo dos Santos Bacci, Janser Moura Pereira, Cíntia Johnston, and Vivian Mara Gonçalves de Oliveira Azevedo
Associação de Medicina Intensiva Brasileira
Objective To identify the neonatal, pediatric and mixed (neonatal and pediatric) intensive care units in Brazil that use cuffed tracheal tubes in clinical practice and to describe the characteristics related to the use of protocols and monitoring. Methods To identify the intensive care units in Brazil, the Ministry of Health’s National Registry of Health Facilities was accessed, and information was collected on 693 registered intensive care units. This was an analytical cross-sectional survey conducted through electronic questionnaires sent to 298 neonatal, pediatric and mixed intensive care units in Brazil. Results This study analyzed 146 questionnaires (49.3% from neonatal intensive care units, 35.6% from pediatric intensive care units and 15.1% from mixed pediatric intensive care units). Most of the participating units (78/146) used cuffed tracheal tubes, with a predominance of use in pediatric intensive care units (52/78). Most of the units that used cuffed tracheal tubes applied a cuff pressure monitoring protocol (45/78). The use of cuff monitoring protocols was observed in intensive care units with a physical therapy service exclusive to the unit (38/61) and in those with a physical therapist present 24 hours/day (25/45). The most frequent cause of extubation failure related to the use of cuffed tracheal tubes in pediatric intensive care units was upper airway obstruction. Conclusion In this survey, the use of cuffed tracheal tubes and the application of a cuff pressure monitoring protocol was predominant in pediatric intensive care units. The use of a monitoring protocol was more common in intensive care units that had a physical therapist who was exclusive to the unit and was present 24 hours/day.
Suzi Laine Longo dos Santos Bacci, Cíntia Johnston, Wallisen Tadashi Hattori, Janser Moura Pereira, and Vívian Mara Gonçalves de Oliveira Azevedo
Sociedade Brasileira de Pneumologia e Tisiologia
ABSTRACT Objective: The aim of this study was to describe practices for weaning from mechanical ventilation (MV), in terms of the use of protocols, methods, and criteria, in pediatric ICUs (PICUs), neonatal ICUs (NICUs), and mixed neonatal/pediatric ICUs (NPICUs) in Brazil. Methods: This was a cross-sectional survey carried out by sending an electronic questionnaire to a total of 298 NICUs, PICUs, and NPICUs throughout Brazil. Results: Completed questionnaires were assessed for 146 hospitals, NICUs accounting for 49.3% of the questionnaires received, whereas PICUs and NPICUs accounted for 35.6% and 15.1%, respectively. Weaning protocols were applied in 57.5% of the units. In the NICUs and NPICUs that used weaning protocols, the method of MV weaning most commonly employed (in 60.5% and 50.0%, respectively) was standardized gradual withdrawal from ventilatory support, whereas that employed in most (53.0%) of the PICUs was spontaneous breathing trial (SBT). During the SBTs, the most common ventilation mode, in all ICUs, was pressure-support ventilation (10.03 ± 3.15 cmH2O) with positive end-expiratory pressure. The mean SBT duration was 35.76 ± 29.03 min in the NICUs, compared with 76.42 ± 41.09 min in the PICUs. The SBT parameters, weaning ventilation modes, and time frame considered for extubation failure were not found to be dependent on the age profile of the ICU population. The findings of the clinical evaluation and arterial blood gas analysis are frequently used as criteria to assess readiness for extubation, regardless of the age group served by the ICU. Conclusions: In Brazil, the clinical practices for weaning from MV and extubation appear to vary depending on the age group served by the ICU. It seems that weaning protocols and SBTs are used mainly in PICUs, whereas gradual withdrawal from ventilatory support is more widely used in NICUs and NPICUs.