Santana Do Acarau

Researchers are conducting an international, multicenter observational study to understand acute kidney injury requiring renal replacement therapy AKI-RRT in Latin American countries. The study focuses on the epidemiology, outcomes, and care processes for patients with AKI-RRT, comparing variations across different countries and examining factors such as demographics, clinical profiles, and socioeconomic status that may influence patient outcomes. The aim is to establish a comprehensive database to support clinical research and improve understanding of AKI-RRT in this region. The study observes critically ill adult patients admitted to intensive care units ICUs who are undergoing any form of renal replacement therapy. It collects detailed clinical, laboratory, treatment, and outcome data without assigning treatments, as it is observational. Patients are followed from enrollment through hospital discharge or up to 90 days, including ICU stay and 90-day post-ICU follow-up to track mortality, renal recovery, and complications related to renal replacement therapy. Participants involvement includes monitoring during ICU and hospital stays with data collected on mortality rates, length of stay, renal function recovery, dependence on renal replacement therapy, and complications such as infections or anticoagulation issues. The primary outcome measured is in-hospital mortality, with secondary outcomes covering ICU mortality, 90-day mortality, length of stay, recovery, and procedural complications. This study spans from enrollment until 90 days after ICU admission, providing extensive observational data on AKI-RRT in Latin America.

Researchers are evaluating the potential benefits and risks of using adjunctive hydrocortisone in children with septic shock that does not respond to fluids and vasoactive medications. The trial aims to determine whether hydrocortisone can reduce the occurrence of new or worsening organ dysfunction and improve outcomes such as survival and quality of life in pediatric patients. This study is a randomized, double-blinded, placebo-controlled trial involving critically ill children in pediatric intensive care units. Participants are randomly assigned to one of two groups one receives hydrocortisone sodium succinate according to a specific dosing schedule, and the other receives a placebo of normal saline with the same volume and schedule. The hydrocortisone treatment starts with a 2 mgkg intravenous bolus followed by 1 mgkg doses every six hours for up to seven days or until vasoactive medications have been stopped for at least 12 hours. The placebo group receives an identical schedule of saline infusions. During the study, children will be monitored closely while in the intensive care unit for adverse events such as high blood sugar, gastrointestinal bleeding, delirium, and hospital-acquired infections. Researchers will assess organ dysfunction using the Pediatric Logistic Organ Dysfunction PELOD-2 tool and evaluate health-related quality of life with the Pediatric Quality of Life Inventory PedsQL at 28 days after enrollment. Follow-up assessments will also occur at 90 days. The study plans to enroll up to 500 children from multiple countries, with the goal of improving treatment guidelines for septic shock in children.

Researchers are conducting an observational, prospective, multicenter cohort study to evaluate patients with severe and very severe Chronic Obstructive Pulmonary Disease COPD in Brazil. The study focuses on patients classified according to the GOLD 2024 guidelines, exploring how COPD severity relates to exacerbation rates, disease progression, complications, and mortality. This study aims to provide national data on this specific subgroup of COPD patients across different Brazilian regions with varying environmental exposures and genetic backgrounds. This non-interventional study will include patients from eight medical centers representing all five regions of Brazil, including teaching and tertiary hospitals. Participants will be enrolled consecutively and followed for 12 months. The study involves on-site visits at enrollment, 6 months, and 12 months, with tele-consults at 3 and 9 months to collect clinical data, especially regarding exacerbations. Participants will undergo evaluations during scheduled visits and tele-consults, with data collected and reviewed by the studys adjudication team. Researchers will measure outcomes such as the incidence of hospitalizations, exacerbations, mortality, vaccination rates, and lung neoplasia over approximately one year. The study emphasizes gathering comprehensive clinical information through direct and remote contacts to understand COPD progression and related health events.