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Fluid balance in pediatric patients in prone position: a pragmatic study
Agnese, Rosirene Maria Frohlich Dall'; Oliveira Filho, Petrônio Fagundes de; Costa, Caroline A. D; Tonial, Cristian T; Bruno, Francisco; Enloft, Paulo R; Fiori, Humberto H; Garcia, Pedro Celiny R.
  • Agnese, Rosirene Maria Frohlich Dall'; Pontifical Catholic University of Rio Grande do Sul. Postgraduate Program on Pediatrics and Children's Health. São Lucas Hospital of PUCRS. Porto Alegre. BR
  • Oliveira Filho, Petrônio Fagundes de; University of Caxias do Sul. Caxias do Sul. BR
  • Costa, Caroline A. D; Pontifical Catholic University of Rio Grande do Sul. Postgraduate Program on Pediatrics and Children's Health. São Lucas Hospital of PUCRS. Porto Alegre. BR
  • Tonial, Cristian T; Pontifical Catholic University of Rio Grande do Sul. Postgraduate Program on Pediatrics and Children's Health. São Lucas Hospital of PUCRS. Porto Alegre. BR
  • Bruno, Francisco; Pontifical Catholic University of Rio Grande do Sul. Postgraduate Program on Pediatrics and Children's Health. São Lucas Hospital of PUCRS. Porto Alegre. BR
  • Enloft, Paulo R; Pontifical Catholic University of Rio Grande do Sul. Postgraduate Program on Pediatrics and Children's Health. São Lucas Hospital of PUCRS. Porto Alegre. BR
  • Fiori, Humberto H; Pontifical Catholic University of Rio Grande do Sul. Postgraduate Program on Pediatrics and Children's Health. São Lucas Hospital of PUCRS. Porto Alegre. BR
  • Garcia, Pedro Celiny R; Pontifical Catholic University of Rio Grande do Sul. Postgraduate Program on Pediatrics and Children's Health. São Lucas Hospital of PUCRS. Porto Alegre. BR
Rev. Assoc. Med. Bras. (1992) ; 65(6): 839-844, June 2019. tab
Article in English | LILACS | ID: biblio-1012996
ABSTRACT
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.
RESUMO
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.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Respiration, Artificial / Water-Electrolyte Balance / Prone Position / Diuresis Type of study: Observational study / Risk factors Limits: Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: Rev. Assoc. Med. Bras. (1992) Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Pontifical Catholic University of Rio Grande do Sul/BR / University of Caxias do Sul/BR

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Full text: Available Index: LILACS (Americas) Main subject: Respiration, Artificial / Water-Electrolyte Balance / Prone Position / Diuresis Type of study: Observational study / Risk factors Limits: Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: Rev. Assoc. Med. Bras. (1992) Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Pontifical Catholic University of Rio Grande do Sul/BR / University of Caxias do Sul/BR