Profile and consequences of children requiring prolonged mechanical ventilation in three Brazilian pediatric intensive care units
| Autor: | Cristiane Traiber, Jefferson Pedro Piva, Verônica Baecker, Carlos C. Fritsher, Fernanda Umpierre Bueno, Eliana A. Trotta, Patricia Miranda do Lago, Claudia Pires Ricachinevsky, Pedro Celiny Ramos Garcia, Bianca D. Lisboa |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Critical Care and Intensive Care Medicine Intensive Care Units Pediatric Patient Admission Critical care nursing Intensive care Medicine Humans Intensive care medicine Child Retrospective Studies Pediatric intensive care unit Mechanical ventilation Potential impact business.industry Infant Retrospective cohort study Prognosis Respiration Artificial Pediatrics Perinatology and Child Health Emergency medicine Female business Brazil |
| Zdroj: | Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 10(3) |
| ISSN: | 1529-7535 |
| Popis: | To describe the characteristics of children submitted to prolonged mechanical ventilation (MV), and evaluate their mortality, and associated factors as well as the potential impact at admissions to the pediatric intensive care unit (PICU).We conducted a retrospective study enrolling all children admitted to three Brazilian PICUs between January 2003 and December 2005 submitted to MVor =21 days. The three selected PICUs were located in university-affiliated hospitals. From the medical charts were reported anthropometric data, diagnosis, ventilator parameters on the 21st day, length of MV, length of stay in the PICU, specific interventions (e.g., tracheostomy), and outcome.One hundred eighty-four children (190 admissions) were submitted to prolonged MV (2.5% of all admissions to these 3 Brazilian PICUs), with a median age of 6 months. The mortality rate was 48% and the median time on MV was 32 days. Tracheostomy was performed on only 19% of the patients and, on average after 32 days of intubation. Mortality was associated with peak inspiratory pressure25 cm H2O (odds ratio = 2.3; 1.1-5.1), fraction of inspired oxygen0.5 (odds ratio = 6.3; 2.2-18.1), and vasoactive drug infusion (odds ratio = 2.6; 1.1-5.9) on the 21st day of MV. Seventy-six children (1% of the all admissions) were dependent on MV without other organ failures were 830 PICU admissions and were potentially prevented.A small group of children admitted to the PICU requires prolonged MV. The elevated mortality rate is associated with higher ventilatory parameters and vasoactive drug support on the 21st day of MV. Stable children requiring prolonged MV in the PICU potentially prevent additional admissions of a large number of acute and unstable patients. |
| Databáze: | OpenAIRE |
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