Congenital diaphragmatic hernia (CDH) is a severe defect with an estimated incidence of 1:3000 live births (). This anomalous condition is characterized by an absence of separation between the thoracic and abdominal cavities during fetal development. Some of the first hypotheses about this congenital defect postulated that the presence of abdominal viscera in the thoracic cavity caused pulmonary hypoplasia by pushing the abdominal contents into the developing lungs (,). After several studies in animal models, a new theory was presented […]

Hemostasis in children and adolescents: ontogenetic characteristics and impact on pediatric thromboembolism During phylogenetic evolution, living beings develop a regulatory hemostatic system for protecting the cardiovascular system. In humans, the hemostatic system has a peculiar ontogenesis, which consists of a dynamic evolutionary process deeply influenced by age. The term “developmental hemostasis” has been used since the 1990s to describe age-dependent changes in the hemostatic system, as seen in (). Children are physiologically protected from thromboembolic events due to a decreased […]

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), became a pandemic in March 2020, affecting millions of people worldwide. However, COVID-19 in pediatric patients represents 1-5% of all cases, and the risk for developing severe disease and critical illness is much lower in children with COVID-19 than in adults. Multisystem inflammatory syndrome in children (MIS-C), a possible complication of COVID-19, has been described as a hyperinflammatory condition with multiorgan involvement similar to that in Kawasaki disease […]

SARS-CoV-2 shares nearly 80% of its’ genomic sequence with SARS-CoV and MERS-CoV, both viruses known to cause respiratory symptoms and liver impairment. The emergence of pediatric cases of multisystem inflammatory syndrome related to the SARS-CoV-2 infection (PIM-TS) has raised concerns over the issue of hepatic damage and liver enzyme elevation in the critically ill pediatric population with COVID-19. Some retrospective cohorts and case series have shown various degrees of ALT/AST elevation in SARS-CoV-2 infections. A limited number of liver histopathological […]

The repercussions of infection by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnant women and newborns are still not well known, with little scientific evidence about their manifestation in the mother-child binomial. Vertical transmission seems possible but has not been documented (,). Furthermore, the virus has not been detected in human milk, enabling breastfeeding with protection or the use of expressed milk from the mother (-). Several studies (,-) published to date suggest the possibility of […]

This article presents expert recommendations for assisting newborn children of mothers with suspected or diagnosed coronavirus disease 2019 (COVID-19). The consensus was developed by five experts with an average of 20 years of experience in neonatal intensive care working at a reference university hospital in Brazil for the care of pregnant women and newborns with suspected or confirmed COVID-19. Despite the lack of scientific evidence regarding the potential for viral transmission to their fetus in pregnant mothers diagnosed with or […]

This review aims to verify the main epidemiologic, clinical, laboratory-related, and therapeutic aspects of coronavirus disease 2019 (COVID-19) in critically ill pediatric patients. An extensive review of the medical literature on COVID-19 was performed, mainly focusing on the critical care of pediatric patients, considering expert opinions and recent reports related to this new disease. Experts from a large Brazilian public university analyzed all recently published material to produce a report aiming to standardize the care of critically ill children and […]