Pediatric unplanned extubation risk score: A predictive model for risk assessment.

Autor: Neves VC; Pediatric Intensive Care Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil; Department of Pediatrics, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil. Electronic address: valeria.neves@hc.ufpr.br., Locatelli CGR; Department of Pediatrics, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil., Ramalho O; Pediatric Intensive Care Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil., Miranda BS; Pediatric Intensive Care Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil., Koliski A; Pediatric Intensive Care Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil; Department of Pediatrics, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil., Nunes ML; Department of Pediatrics, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil., Carreiro JE; Pediatric Intensive Care Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil; Department of Pediatrics, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil.
Jazyk: angličtina
Zdroj: Heart & lung : the journal of critical care [Heart Lung] 2023 Nov-Dec; Vol. 62, pp. 50-56. Date of Electronic Publication: 2023 Jun 10.
DOI: 10.1016/j.hrtlng.2023.05.021
Abstrakt: Background: Unplanned extubation is one of the most common preventable adverse events associated with invasive mechanical ventilation.
Objective: This research study aimed to develop a predictive model to identify the risk of unplanned extubation in a pediatric intensive care unit (PICU).
Methods: This single-center, observational study was conducted at the PICU of the Hospital de Clínicas. Patients were included based on the following criteria: aged between 28 days and 14 years, intubated, and using invasive mechanical ventilation.
Results: Over 2 years, 2,153 observations were made using the Pediatric Unplanned Extubation Risk Score predictive model. Unplanned extubation occurred in 73 of 2,153 observations. A total of 286 children participated in the application of the Risk Score. This predictive model was created to categorize the following significant risk factors: 1) inadequate placement and fixation of the endotracheal tube (odds ratio 2.00 [95%CI,1.16-3.36]), 2) Insufficient level of sedation (odds ratio 3.00 [95%CI,1.57-4.37]), 3) age ≤ 12 months (odds ratio 1.27 [95%CI,1.14-1.41]), 4) presence of airway hypersecretion (odds ratio 11.00 [95%CI,2,58-45.26]) inadequate family orientation and/or nurse to patient ratio (odds ratio 5.00 [95%CI,2.64-7.99]), and 6) weaning period from mechanical ventilation (odds ratio 3.00 [95%CI,1.67-4.79]) and 5 risk enhancement factors.
Conclusions: The scoring system demonstrated effective sensitivity for estimating the risk of UE with the observation of six aspects, which overlap as an isolated risk factor or are associated with a risk enhancement factors.
Competing Interests: Declaration of Competing Interest This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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