Resumo O gênero Tibouchina apresenta aproximadamente 350 espécies, dentre elas, Tibouchina affinis fothergillae, Tibouchina heteromalla, Tibouchina moricandiana var. vinaceae e Tibouchina sellowiana. Por se tratarem de espécies nativas do Brasil, podem ser utilizadas para revegetação de áreas antropizadas, devido à característica pioneira. A presente pesquisa objetivou estudar a propagação vegetativa via miniestaquia, utilizando ácido indol butírico (AIB) e ácido fúlvico (AF), bem como realizar determinações bioquímicas e quantificar a produtividade de minicepas destas espécies. Os propágulos foram coletados de um minijardim clonal, nos meses de abril, junho, setembro e novembro/2017, confeccionados com 5+1 cm de comprimento, corte em bisel na base e reto no ápice, mantendo-se um par de folhas reduzidas à metade. As bases das miniestacas foram submetidas aos tratamentos: 0 mg L-1AIB/AF, 2000 mg L-1AIB, 2000 mg L-1AF e 2000 mg L-1AIB+AF. O experimento foi instalado utilizando-se tubetes de 53 cm³ com vermiculita, avaliados após 33 dias de permanência em casa de vegetação, considerando-se a porcentagem de enraizamento das miniestacas. O delineamento foi inteiramente casualizado, num esquema fatorial de 4x4 (quatro épocas de coleta x quatro tratamentos), conduzido individualmente/espécie. As espécies não responderam aos tratamentos com AIB/AF. Nas diferentes épocas de coleta dos propágulos, o enraizamento foi superior a 95% para todas as espécies em abril, setembro e novembro, exceto para Tibouchina sellowiana com 49% de enraizamento no mês de novembro, demonstrando o efeito direto das condições ambientais as quais as plantas matrizes estavam sujeitas, sob a rizogênese. Conclui-se que não há necessidade da aplicação de AIB/AF para a propagação vegetativa das diferentes espécies de Tibouchina, sendo viável o uso da técnica de miniestaquia. Visando a maior produtividade de miniestacas, recomenda-se coletar os propágulos em abril para Tibouchina affinis fothergillae e Tibouchina moricandiana var. vinaceae, em novembro para Tibouchina heteromalla e em junho para Tibouchina sellowiana.

Abstract Tibouchina gene showed approximately 350 species, among these, Tibouchina affinis fothergillae, Tibouchina heteromalla, Tibouchina moricandiana var. vinaceae, Tibouchina sellowiana, are native species of Brazil, were used for revegetation in anthropized areas, due to the pioneerinh chacacteristic. The present research aimed to study rhizogenic from the technique of plant propagation by minicutting with the use of indole-3-butyric acid (IBA) and fulvic acid (FA), biochemical determinations, in addition to the ministumps production. The minicuttings were sampled in april, june, september and november and prepared with 5+1 cm length, bevel cut at the base and straight in the apical portion, keeping two leaves reduced to half. The bases of the minicuttings were to put to different treatments: 0 mg L-1 IBA/FA, 2000 mg L-1 IBA, 2000 mg L-1 FA and 2000 mg L-1 IBA+FA. The installation was in tubes with 53 cm3 with vermiculite, evaluating after 33 days of stay in the greenhouse, analyzed the rooting percentage of minicutting. The experimental design was completely randomized in a factorial of 4x4 (4 sample x 4 treatments). Rooting was greater than 95% for all species in the samples held in april, september and november, except to Tibouchina sellowiana with 49% of rooting in the month of November, showing the direct effect of the environment under the rizogenic. Concluded was unnecessary supplementation with exogenous IBA and FA for technical minicutting of different Tibouchina species. The production of minicutting was viable in april for Tibouchina affinis fothergillae and Tibouchina moricandiana var. vinaceae, in november Tibouchina heteromalla and june Tibouchina sellowiana.

ABSTRACT We aimed to verify the morphophysiological changes in jaboticaba tree (Plinia peruviana (Poir.) Govaerts) saplings under shade gradient to improve knowledge on the appropriate light environmental conditions for the saplings production and field homogeneous or intercropping cultivation of this species. The saplings were grown under full sun and artificial shade levels (30%, 50%, and 80%). Growth, photosynthetic pigments, gas exchanges, chlorophyll fluorescence, and leaf anatomy characters were evaluated. Our results showed that jaboticaba tree saplings growth was improved under full sun and 30% of shade. Under 50% and 80% shade the saplings demonstrate phenotypic plasticity, such as larger and thinner leaves. Chlorophyll fluorescence, chlorophyll content, and quantum yield of photosystem II were higher under higher shade level, but the CO2 assimilation rate was not different between light conditions. These changes are typically found in shade-tolerant plants and is related to perform photosynthesis more efficiently in highly variable light conditions. Despite that, we recommend that cultivation be carried out under full sun or up to 30% shade to maximize jaboticaba tree saplings growth in nurseries and orchards.

Abstract Plinia cauliflora is an important Brazilian species that produces highly appreciated fruits, with a great potential of commercialization. However, the high cost of seedlings is a bottleneck for the expansion of commercial orchards. The present study aimed to investigate somatic embryogenesis as a propagation method for P. cauliflora using seeds as explants. To induce embryogenic mass (EM) and somatic embryo (SE) development we evaluated the supplementation of culture medium with different concentrations of 2,4-dichlorophenoxyacetic acid (2,4-D), combined or not with activated charcoal (AC). For the embryo maturation, we investigated the effects of AC, polyethylene glycol (PEG), Gelzan®, 6-benzylaminopurine and gibberellin supplementation. For the EM induction, the best results were obtained in MS culture medium supplemented with 300 μM 2,4-D and 1 g L-1 AC. During the first maturation phase, the supplementation of 30 g L-1 PEG improved the somatic embryo formation at the torpedo and cotyledonary stages, whereas the maturation treatments did not result in the conversion of the embryos into plantlets. The anatomical analysis showed that the 2,4-D presence for 60 days may have been deleterious for embryonic development. These results represent the first report of P. cauliflora somatic embryogenesis and its feasibility for mass propagation.

Abstract Objective: To determine the prevalence of life support limitation (LSL) in patients who died after at least 24 h of a pediatric intensive care unit (PICU) stay, parent participation and to describe how this type of care is delivered. Methods: Retrospective cohort study in a tertiary PICU at a university hospital in Brazil. All patients aged 1 month to 18 years who died were eligible for inclusion. The exclusion criteria were those brain death and death within 24 h of admission. Results: 53 patients were included in the study. The prevalence of a LSL report was 45.3%. Out of 24 patients with a report of LSL on their medical records only 1 did not have a donot-resuscitate order. Half of the patients with a report of LSL had life support withdrawn. The length of their PICU stay, age, presence of parents at the time of death, and severity on admission, calculated by the Pediatric Index of Mortality 2, were higher in patients with a report of LSL. Compared with other historical cohorts, there was a clear increase in the prevalence of LSL and, most importantly, a change in how limitations are carried out, with a high prevalence of parental participation and an increase in withdrawal of life support. Conclusions: LSLs were associated with older and more severely ill patients, with a high prevalence of family participation in this process. The historical comparison showed an increase in LSL and in the withdrawal of life support.

Abstract Objective To evaluate the prognostic performance of the Pediatric Index of Mortality 2 (PIM2), ferritin, lactate, C-reactive protein (CRP), and leukocytes, alone and in combination, in pediatric patients with sepsis admitted to the pediatric intensive care unit (PICU). Methods A retrospective study was conducted in a PICU in Brazil. All patients aged 6 months to 18 years admitted with a diagnosis of sepsis were eligible for inclusion. Those with ferritin and C-reactive protein measured within 48 h and lactate and leukocytes within 24 h of admission were included in the prognostic performance analysis. Results Of 350 eligible patients with sepsis, 294 had undergone all measurements required for analysis and were included in the study. PIM2, ferritin, lactate, and CRP had good discriminatory power for mortality, with PIM2 and ferritin being superior to CRP. The cutoff values for PIM2 (> 14%), ferritin (> 135 ng/mL), lactate (> 1.7 mmol/L), and CRP (> 6.7 mg/mL) were associated with mortality. The combination of ferritin, lactate, and CRP had a positive predictive value of 43% for mortality, similar to that of PIM2 alone (38.6%). The combined use of the three biomarkers plus PIM2 increased the positive predictive value to 76% and accuracy to 0.945. Conclusions PIM2, ferritin, lactate, and CRP alone showed good prognostic performance for mortality in pediatric patients older than 6 months with sepsis. When combined, they were able to predict death in three-fourths of the patients with sepsis. Total leukocyte count was not useful as a prognostic marker.

ABSTRACT. Grafting is an alternative method for the early production of Araucaria angustifolia seeds, and welding quality is essential for the success of the technique. The objective of this study was to create a classification of welding quality to estimate the percentage of scion survival. The patch and flute grafting techniques were used in a greenhouse and in the field. Survival was evaluated 270 days after grafting (DAG). At 60 DAG, observations of the graft connection region were made with the naked eye, classifying the connections into four welding classes. After 160 DAG, transverse cuts were performed on each class and visually and anatomically evaluated. Flute grafting presented higher initial survival (79%), but at 180 DAG, the survival rate of both techniques was similar (48% for flute and 41% for patch). There was greater scion survival for the class that had only two regions in contact with discontinuity in the bark. Stabilization of survival occurred after 180 DAG, regardless of the welding class. Visually, there were differences in welding quality; however, anatomically, all classes presented vascular connections. The visual welding quality assessment underestimated the percentage of scion survival. However, the vascular connection and development of parenchymatous tissue are promising for diagnosing grafting success.

Resumo: Em um processo de fluxo múltiplo (MSP) um produto é fabricado em vários fluxos em paralelo. A ferramenta tradicional para o monitoramento de MSPs é o gráfico de controle de grupo (GCG), que não leva em conta que tipicamente o valor da característica de qualidade em cada fluxo é a soma de um componente comum a todos os fluxos e um componente individual, do fluxo particular. Isso pode tornar o GCG ineficaz na detecção de mudanças na média de fluxos individuais. Com base neste modelo de dois componentes, propomos um GCG da média móvel ponderada exponencialmente (EWMA) para monitorar as médias dos componentes individuais dos fluxos. Otimizamos seu projeto (minimizando o ARL para determinados deslocamentos na média de um fluxo) e comparamos seus ARLs com os de outros gráficos destinados a MSPs de dois componentes. Para essa comparação, precisávamos obter os projetos ótimos também desses gráficos anteriores, que não estavam disponíveis na literatura; essa é uma contribuição adicional do nosso trabalho. Os ARLs dos gráficos foram obtidos por simulação, com um número de corridas suficientemente grande para garantir a precisão dos resultados. Estes mostram que o gráfico proposto supera os anteriores, tornando-se recomendado para o controle de MSPs.

Abstract: In a multiple stream process (MSP) a product is manufactured in a number of streams in parallel. The traditional tool for monitoring MSPs, the group control chart (GCC), does not take into account that typically the value of the quality variable in each stream is the sum of a component common to all streams and an individual component, of the particular stream. This may render the GCC ineffective in detecting shifts in the mean of individual streams. Based on this two-components model, we propose an exponentially weighted moving average (EWMA) GCC to monitor the means of the individual streams components. We optimize its design (minimizing the ARL for given shifts in the mean of a stream) and compare their ARLs with the ones of other existing charts devised for two-components MSPs. For this comparison, we needed to obtain optimal designs of these previous charts too, which were not available in the literature; this is an additional contribution of our work. The ARLs of the charts were obtained by simulation, with a number of runs sufficiently large to ensure precise results. The results show that the proposed chart outperforms the previous ones, becoming thus recommended for the statistical control of MSPs.

RESUMO Racional: A melhor técnica de hernioplastia incisional ainda não foi definida. Uma das dificuldades na comparação é a heterogenicidade no perfil dos pacientes avaliados. Objetivo: Analisar os resultados de três técnicas de hernioplastia incisional após cirurgia bariátrica aberta. Método: Os pacientes que realizaram hernioplastias incisionais foram estudados e divididos em três grupos: técnica onlay, sutura simples e técnica retromuscular. Resultados e qualidade de vida após o reparo utilizando o Carolina’s Comfort Scale foram avaliados através de análise de prontuários, contato telefônico e consultas eletivas. Resultados: Foram analisados 363 relatos cirúrgicos e 263 foram incluídos: técnica onlay (n=89), sutura simples (n=100), técnica retromuscular (n=74). O perfil epidemiológico dos pacientes foi similar entre os grupos. A técnica onlay apresentou maiores taxas de seroma (28,89%) e usou dreno com maior frequência (55,56%). A sutura simples obteve maior tempo de internação (2,86 dias). O escore de qualidade de vida foi pior na técnica retromuscular (8,43) em relação à onlay (4,7) e à sutura simples (2,34), especialmente devido às queixas de dor crônica. Não houve diferença quanto a recidiva em curto prazo. Conclusão: A técnica retromuscular apresentou pior qualidade de vida do que as demais técnicas em um grupo homogêneo de pacientes. Os três grupos não mostraram diferenças em termos de recidiva de hérnia em curto prazo.

ABSTRACT Background: The best technique for incisional hernioplasty has not been established yet. One of the difficulties to compare these techniques is heterogeneity in the profile of the patients evaluated. Aim: To analyze the results of three techniques for incisional hernioplasty after open bariatric surgery. Method: Patients who underwent incisional hernioplasty were divided into three groups: onlay technique, simple suture and retromuscular technique. Results and quality of life after repair using Carolina’s Comfort Scale were evaluated through analysis of medical records, telephone contact and elective appointments. Results: 363 surgical reports were analyzed and 263 were included: onlay technique (n=89), simple suture (n=100), retromuscular technique (n=74). The epidemiological profile of patients was similar between groups. The onlay technique showed higher seroma rates (28.89%) and used a surgical drain more frequently (55.56%). The simple suture technique required longer hospital stay (2.86 days). The quality of life score was worse for the retromuscular technique (8.43) in relation to the onlay technique (4.7) and the simple suture (2.34), especially because of complaints of chronic pain. There was no difference in short-term recurrence. Conclusion: The retromuscular technique showed a worse quality of life than the other techniques in a homogeneous group of patients. The three groups showed no difference in terms of short-term hernia recurrence.

ABSTRACT. Plinia peruviana is a species that is native to Brazil and is important due to the taste and medicinal properties of its fruits. Young leaves and split mature seeds were used as explants to initiate somatic embryogenesis to obtain a large number of plants in a short period of time. Leaf discs were cultured in MS medium containing various concentrations of 2,4-D (2,4-dichlorophenoxyacetic acid) or picloram (4-amino-3,5,6-trichloro-2-pyridinecarboxylic acid). In the case of the mature seeds, various concentrations of glutamine, 2,4-D and a combination of auxin and BAP (6-benzylaminopurine) were tested for somatic embryogenesis induction. For somatic embryo maturation, several concentrations of PEG 6000 (polyethylene glycol; up to 90 g L-1) were tested. After 60 days of culture using leaf discs, callus formation occurred in all treatments, with the highest averages obtained with 10 μM 2,4-D. However, these calluses did not form somatic embryos. For the cultured seeds, the best treatment was the MS medium with 1,000 mg L-1 glutamine and 10 μM 2,4-D without BAP. The supplementation of 60 g L-1 PEG 6000 was sufficient to promote the maturation of the somatic embryos. Histological analyses of the calluses that were formed from leaf discs showed nonembryogenic characteristics. In contrast, the calluses that originated from mature seeds had small and round cells with little vacuolation, which are characteristics of embryogenic structures.

RESUMO Objetivo: realizar um diagnóstico situacional do comportamento de profissionais de saúde quanto às práticas de higienização das mãos em setores de alta complexidade. Métodos: estudo quantitativo, retrospectivo, baseado em relatórios (anos de 2016 e 2017) dos setores CTI Adulto e Pediátrico de um hospital Federal do Rio de Janeiro. Resultados: analisaram-se 1.258 oportunidades para higiene das mãos. A chance de um profissional higienizar as mãos no CTI Pediátrico é 41,61% maior que no CTI Adulto. Quanto higienizar as mãos adequadamente, a equipe médica obteve chance 39,44% menor que a equipe de enfermagem e outros tiveram chance 30,62% menor quando comparada à equipe da enfermagem. O momento “após o contato com o paciente” apresentou 4,5275 vezes a chance em relação a “antes do contato com o paciente”. Conclusão: frente à recomendação da higiene das mãos no controle da COVID-19, avaliação diagnóstica e análise prévia do comportamento dos profissionais demonstrou ser positiva.

ABSTRACT Objective: to perform a situational diagnosis of the behavior of health professionals concerning hand hygiene practices in highly-complex sectors. Methods: this quantitative and retrospective study was based on reports (2016 and 2017) of Adult and Pediatric ICUs of a Federal hospital in Rio de Janeiro. Results: one thousand two hundred fifty-eight opportunities for hand hygiene were analysed. The chance of professionals sanitizing hands in Pediatric ICUs is 41.61% higher than in Adult ICUs. Concerning proper hand hygiene, the medical team had a 39.44% lower chance than the nursing team. Others had a 30.62% lower chance when compared to the nursing team. The moment “after contact with the patient” presented 4.5275 times the chance in relation “before contact with the patient”. Conclusion: in front of hand hygiene recommendations to control COVID-19, diagnostic assessment and previous analysis of the behavior of professionals proved to be positive.

RESUMEN Objetivo: realizar un diagnóstico situacional del comportamiento de los profesionales de la salud con respecto a las prácticas de higiene de manos en sectores altamente complejos. Métodos: estudio cuantitativo, retrospectivo, basado en informes (años 2016 y 2017) de los sectores de UCI Adultos y Pediátricos de un hospital federal en Rio de Janeiro. Resultados: se analizaron 1.258 oportunidades de higiene de manos. La posibilidad de un lavado de manos profesional en la UCI Pediátrica es 41.61% mayor que en la UCI Adultos. Con respecto a la higiene de las manos, el equipo médico tuvo una probabilidad 39.44% menor que el equipo de enfermería y otros tuvieron una probabilidad 30.62% menor en comparación con el equipo de enfermería. El momento “después del contacto con el paciente” fue 4.5275 veces mayor que “antes del contacto con el paciente”. Conclusión: contra la recomendación de higiene de manos en el control de COVID-19, la evaluación diagnóstica y el análisis previo del comportamiento de los profesionales resultaron ser positivos.

ABSTRACT Objective: to perform a situational diagnosis of the behavior of health professionals concerning hand hygiene practices in highly-complex sectors. Methods: this quantitative and retrospective study was based on reports (2016 and 2017) of Adult and Pediatric ICUs of a Federal hospital in Rio de Janeiro. Results: one thousand two hundred fifty-eight opportunities for hand hygiene were analysed. The chance of professionals sanitizing hands in Pediatric ICUs is 41.61% higher than in Adult ICUs. Concerning proper hand hygiene, the medical team had a 39.44% lower chance than the nursing team. Others had a 30.62% lower chance when compared to the nursing team. The moment “after contact with the patient” presented 4.5275 times the chance in relation “before contact with the patient”. Conclusion: in front of hand hygiene recommendations to control COVID-19, diagnostic assessment and previous analysis of the behavior of professionals proved to be positive.

RESUMEN Objetivo: realizar un diagnóstico situacional del comportamiento de los profesionales de la salud con respecto a las prácticas de higiene de manos en sectores altamente complejos. Métodos: estudio cuantitativo, retrospectivo, basado en informes (años 2016 y 2017) de los sectores de UCI Adultos y Pediátricos de un hospital federal en Rio de Janeiro. Resultados: se analizaron 1.258 oportunidades de higiene de manos. La posibilidad de un lavado de manos profesional en la UCI Pediátrica es 41.61% mayor que en la UCI Adultos. Con respecto a la higiene de las manos, el equipo médico tuvo una probabilidad 39.44% menor que el equipo de enfermería y otros tuvieron una probabilidad 30.62% menor en comparación con el equipo de enfermería. El momento “después del contacto con el paciente” fue 4.5275 veces mayor que “antes del contacto con el paciente”. Conclusión: contra la recomendación de higiene de manos en el control de COVID-19, la evaluación diagnóstica y el análisis previo del comportamiento de los profesionales resultaron ser positivos.

RESUMO Objetivo: realizar um diagnóstico situacional do comportamento de profissionais de saúde quanto às práticas de higienização das mãos em setores de alta complexidade. Métodos: estudo quantitativo, retrospectivo, baseado em relatórios (anos de 2016 e 2017) dos setores CTI Adulto e Pediátrico de um hospital Federal do Rio de Janeiro. Resultados: analisaram-se 1.258 oportunidades para higiene das mãos. A chance de um profissional higienizar as mãos no CTI Pediátrico é 41,61% maior que no CTI Adulto. Quanto higienizar as mãos adequadamente, a equipe médica obteve chance 39,44% menor que a equipe de enfermagem e outros tiveram chance 30,62% menor quando comparada à equipe da enfermagem. O momento “após o contato com o paciente” apresentou 4,5275 vezes a chance em relação a “antes do contato com o paciente”. Conclusão: frente à recomendação da higiene das mãos no controle da COVID-19, avaliação diagnóstica e análise prévia do comportamento dos profissionais demonstrou ser positiva.

Abstract Titanium dioxide nanoparticles (TiO2NPs) are widely used and may impact the environment. Thus, this study used a high concentration of TiO2NP (1000 mg/L) to verify the defense mechanisms triggered by a plant system – an indicator of toxicity. Furthermore, this study aimed at completely characterizing TiO2NP suspensions to elucidate their toxic behavior. TiO2NPs were taken up by meristematic cells of Allium cepa, leading to slight inhibition of seed germination and root growth. However, severe cellular and DNA damages were observed in a concentration-dependent manner (10, 100, and 1000 mg/L). For this reason, we used the highest tested concentration (1000 mg/L) to verify if the plant cells developed defense mechanisms against the TiO2NPs and evaluated other evidences of TiO2NP genotoxicity. Nucleolar alterations and plant defense responses (i.e., increased lytic vacuoles, oil bodies and NP phase change) were observed in meristematic cells exposed to TiO2NP at 1000 mg/L. In summary, TiO2NPs can damage the genetic material of plants; however, plants displayed defense mechanisms against the deleterious effects of these NPs. In addition, A. cepa was found to be a suitable test system to evaluate the cyto- and genotoxicity of NPs.

RESUMO OBJETIVO: Verificar a associação entre posição prona, aumento da diurese e diminuição do balanço hídrico em pacientes pediátricos criticamente enfermos e submetidos à ventilação mecânica (VM) por causa pulmonar, além de descrever eventuais intercorrências relacionadas à aplicação dessa posição. MÉTODOS: Estudo observacional retrospectivo. Pacientes submetidos à VM por causa pulmonar, com idade entre 1 mês e 12 anos no período entre janeiro de 2013 e dezembro de 2015, foram selecionados e divididos entre os que receberam posição prona (GP) e os que não receberam (GC) durante a internação na Unidade de Terapia Intensiva Pediátrica (Utip). Os dados foram analisados longitudinalmente de D1 a D4. RESULTADOS: Foram analisados77 pacientes (GP=37 e GC=40). Em termos de características gerais, os grupos foram semelhantes entre si. Na comparação entre os grupos, não houve aumento da diurese ou diminuição do balanço hídrico cumulativo no grupo prona. Na análise longitudinal de D1 a D4, evidenciou-se que o GP apresentou maior diurese (p=0,034) e menor balanço hídrico cumulativo (p = 0,001) no D2. Com relação ao uso de diuréticos, houve maior uso de furosemida (P<0,001) e de espironolactona (P=0,04) no GP. Não houve aumento de eventos adversos durante a utilização da posição prona. CONCLUSÃO: A posição prona não demonstrou associação com aumento da diurese ou diminuição de balanço hídrico cumulativo em pacientes críticos pediátricos submetidos à VM por causa pulmonar.

SUMMARY OBJECTIVE: To verify the association between prone position, increased diuresis, and decreased cumulative fluid balance in critically ill pediatric patients who underwent mechanical ventilation (MV) for pulmonary causes and describe adverse events related to the use of the position. METHODS: This is a retrospective observational study. Patients aged between 1 month and 12 years who underwent MV for pulmonary causes, between January 2013 and December 2015, were selected and divided between those who were put on prone position (PG) and those who were not (CG) during the hospitalization at the Pediatric Intensive Care Unit (PICU). Data were analyzed longitudinally from D1 to D4. RESULTS: A total of 77 patients (PG = 37 and CG = 40) were analyzed. The general characteristics of both groups were similar. In the comparison between the groups, there was no increase in diuresis or decrease in cumulative fluid balance in the prone group. In the longitudinal analysis of D1 to D4, we saw that the PG presented higher diuresis (p = 0.034) and a lower cumulative fluid balance (p = 0.001) in D2. Regarding the use of diuretics, there was greater use of furosemide (P <0.001) and spironolactone (P = 0.04) in the PG. There was no increase in adverse events during the use of the prone position. CONCLUSION: The prone position was not associated with increased diuresis or decreased cumulative fluid balance in critically ill pediatric patients who underwent to MV for pulmonary causes.