How is mechanical ventilation employed in a pediatric intensive care unit in Brazil?
Clinics
;
64(12): 1161-1166, 2009. tab, graf
Artículo
en Inglés
| LILACS
| ID: lil-536219
ABSTRACT
OBJECTIVE:
to investigate the relationship between mechanical ventilation and mortality and the practice of mechanical ventilation applied in children admitted to a high-complexity pediatric intensive care unit in the city of São Paulo, Brazil.DESIGN:
Prospective cohort study of all consecutive patients admitted to a Brazilian high-complexity PICU who were placed on mechanical ventilation for 24 hours or more, between October 1st, 2005 and March 31st, 2006.RESULTS:
Of the 241 patients admitted, 86 (35.7 percent) received mechanical ventilation for 24 hours or more. Of these, 49 met inclusion criteria and were thus eligible to participate in the study. Of the 49 patients studied, 45 had chronic functional status. The median age of participants was 32 months and the median length of mechanical ventilation use was 6.5 days. The major indication for mechanical ventilation was acute respiratory failure, usually associated with severe sepsis / septic shock. Pressure ventilation modes were the standard ones. An overall 10.37 percent incidence of Acute Respiratory Distress Syndrome was found, in addition to tidal volumes > 8 ml/kg, as well as normo- or hypocapnia. A total of 17 children died. Risk factors for mortality within 28 days of admission were initial inspiratory pressure, pH, PaO2/FiO2 ratio, oxygenation index and also oxygenation index at 48 hours of mechanical ventilation. Initial inspiratory pressure was also a predictor of mechanical ventilation for periods longer than 7 days.CONCLUSION:
Of the admitted children, 35.7 percent received mechanical ventilation for 24 h or more. Pressure ventilation modes were standard. Of the children studied, 91 percent had chronic functional status. There was a high incidence of Acute Respiratory Distress Syndrome, but a lung-protective strategy was not fully implemented. Inspiratory pressure at the beginning of mechanical ventilation was a predictor of mortality within 28 days and of a longer...
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Respiración Artificial
/
Insuficiencia Respiratoria
Tipo de estudio:
Estudio de etiología
/
Estudio observacional
/
Estudio pronóstico
Límite:
Child, preschool
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
Clinics
Asunto de la revista:
Medicina
Año:
2009
Tipo del documento:
Artículo
País de afiliación:
Argentina
/
Brasil
Institución/País de afiliación:
Buenos Aires University/AR
/
Universidade de São Paulo/BR
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