How is mechanical ventilation employed in a pediatric intensive care unit in Brazil?
Clinics
;
64(12): 1161-1166, 2009. tab, graf
Article
Dans Anglais
| 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...
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Ventilation artificielle
/
Insuffisance respiratoire
Type d'étude:
Etude d'étiologie
/
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Enfant d'âge préscolaire
/
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Brésil
langue:
Anglais
Texte intégral:
Clinics
Thème du journal:
Médicament
Année:
2009
Type:
Article
Pays d'affiliation:
Argentine
/
Brésil
Institution/Pays d'affiliation:
Buenos Aires University/AR
/
Universidade de São Paulo/BR
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