Estatísticas

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      "titulo" => "Efeitos hemodinâmicos e metabólicos da infusão de vasopressina em crianças com choque"
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          "autoresLista" => "Elisa Baldasso, Pedro Celiny Ramos Garcia, Jefferson P. Piva, Paulo Roberto Einloft"
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      "titulo" => "Perspectivas atuais do tratamento da cetoacidose diabética em pediatria"
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    "titulo" => "Controle glicêmico e terapia insulínica em sepse e doença crítica"
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        "autoresLista" => "Ricardo Garcia Branco, Robert Charles Tasker, Pedro Celiny Ramos Garcia, Jefferson Pedro Piva, Lisandra Dias Xavier"
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          <html><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To review the literature about the pathophysiology of hyperglycemia and glycemic control in children and adults with sepsis and critical illness.</p>\n
          \t\t\t\t\t\t   </span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Sources</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Non-systematic survey of the medical literature using MEDLINE and terms hyperglycemia, glycemic control, intensive insulin therapy, sepsis and intensive care. Articles were selected according to their relevance based on the authors&rsquo; opinion.</p>\n
          \t\t\t\t\t\t   </span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Summary of the findings</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hyperglycemia is frequent in critically ill children and it is associated with worsened outcome. In adults, there is no consensus on the efficacy and safety of glycemic control. We describe the possible mechanisms involved in glucose toxicity and the beneficial effects of glycemic control. Initial studies showed that use of insulin to achieve glycemic control reduced morbidity and mortality in adult intensive care; however, recent studies have failed to confirm these findings. Importantly, it is evident that glycemic control is associated with increased incidence of hypoglycemia. The efficacy of glycemic control has not yet been studied in critically ill children.</p>\n
          \t\t\t\t\t\t   </span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conclusion</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Glycemic control is a novel therapeutic option in critical care. Conflicting evidence in adults means that before we apply this approach to pediatrics it will need to be assessed in clinical trial.</p>\n
          \t\t\t\t\t\t   </span></html>
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        "resumen" => "<html><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Revisar a literatura sobre a fisiopatologia de hiperglicemia e controle glic&ecirc;mico em crian&ccedil;as e adultos com sepse e doen&ccedil;a cr&iacute;tica.</p></span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fontes de dados</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pesquisa n&atilde;o sistem&aacute;tica da literatura m&eacute;dica atrav&eacute;s da base de dados MEDLINE usando os termos hiperglicemia, controle glic&ecirc;mico, terapia insul&iacute;nica intensiva, sepse e terapia intensiva. Os artigos foram selecionados de acordo com sua relev&acirc;ncia, conforme a opini&atilde;o dos autores.</p></span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">S&iacute;ntese dos dados</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A hiperglicemia &eacute; freq&uuml;ente em crian&ccedil;as com doen&ccedil;as cr&iacute;ticas e est&aacute; associada a desfecho negativo. Em adultos, n&atilde;o h&aacute; um consenso sobre a efic&aacute;cia e seguran&ccedil;a do controle glic&ecirc;mico. Descrevemos os poss&iacute;veis mecanismos envolvidos em toxicidade da glicose e os efeitos ben&eacute;ficos do controle glic&ecirc;mico. Estudos iniciais demonstraram que o uso de insulina para atingir controle glic&ecirc;mico reduziu a morbimortalidade em terapia intensiva em adultos; no entanto, estudos recentes n&atilde;o confirmaram esses achados. &Eacute; importante destacar que o controle glic&ecirc;mico est&aacute; evidentemente associado a aumento da incid&ecirc;ncia de hipoglicemia. A efic&aacute;cia do controle glic&ecirc;mico ainda n&atilde;o foi estudada em crian&ccedil;as criticamente doentes.</p></span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conclus&atilde;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O controle glic&ecirc;mico &eacute; uma nova op&ccedil;&atilde;o terap&ecirc;utica em terapia intensiva. Evid&ecirc;ncias conflitantes em adultos significam que, antes de aplicar esta abordagem em pediatria, &eacute; necess&aacute;rio avali&aacute;-la em ensaio cl&iacute;nico.</p></span></html>"
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