Cargando…

How is Mechanical Ventilation Employed in a Pediatric Intensive Care Unit in Brazil?

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 pat...

Descripción completa

Detalles Bibliográficos
Autores principales: da Silva, Dafne Cardoso Bourguignon, Shibata, Audrey Rie Ogawa, Farias, Julio A, Troster, Eduardo Juan
Formato: Texto
Lenguaje:English
Publicado: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797584/
https://www.ncbi.nlm.nih.gov/pubmed/20037703
http://dx.doi.org/10.1590/S1807-59322009001200005
_version_ 1782175637737308160
author da Silva, Dafne Cardoso Bourguignon
Shibata, Audrey Rie Ogawa
Farias, Julio A
Troster, Eduardo Juan
author_facet da Silva, Dafne Cardoso Bourguignon
Shibata, Audrey Rie Ogawa
Farias, Julio A
Troster, Eduardo Juan
author_sort da Silva, Dafne Cardoso Bourguignon
collection PubMed
description 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 1(st), 2005 and March 31(st), 2006. RESULTS: Of the 241 patients admitted, 86 (35.7%) 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% 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% received mechanical ventilation for 24 h or more. Pressure ventilation modes were standard. Of the children studied, 91% 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 course of mechanical ventilation.
format Text
id pubmed-2797584
institution National Center for Biotechnology Information
language English
publishDate 2009
publisher Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
record_format MEDLINE/PubMed
spelling pubmed-27975842009-12-24 How is Mechanical Ventilation Employed in a Pediatric Intensive Care Unit in Brazil? da Silva, Dafne Cardoso Bourguignon Shibata, Audrey Rie Ogawa Farias, Julio A Troster, Eduardo Juan Clinics (Sao Paulo) Clinical Science 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 1(st), 2005 and March 31(st), 2006. RESULTS: Of the 241 patients admitted, 86 (35.7%) 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% 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% received mechanical ventilation for 24 h or more. Pressure ventilation modes were standard. Of the children studied, 91% 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 course of mechanical ventilation. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2009-12 /pmc/articles/PMC2797584/ /pubmed/20037703 http://dx.doi.org/10.1590/S1807-59322009001200005 Text en Copyright © 2009 Hospital das Clínicas da FMUSP
spellingShingle Clinical Science
da Silva, Dafne Cardoso Bourguignon
Shibata, Audrey Rie Ogawa
Farias, Julio A
Troster, Eduardo Juan
How is Mechanical Ventilation Employed in a Pediatric Intensive Care Unit in Brazil?
title How is Mechanical Ventilation Employed in a Pediatric Intensive Care Unit in Brazil?
title_full How is Mechanical Ventilation Employed in a Pediatric Intensive Care Unit in Brazil?
title_fullStr How is Mechanical Ventilation Employed in a Pediatric Intensive Care Unit in Brazil?
title_full_unstemmed How is Mechanical Ventilation Employed in a Pediatric Intensive Care Unit in Brazil?
title_short How is Mechanical Ventilation Employed in a Pediatric Intensive Care Unit in Brazil?
title_sort how is mechanical ventilation employed in a pediatric intensive care unit in brazil?
topic Clinical Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797584/
https://www.ncbi.nlm.nih.gov/pubmed/20037703
http://dx.doi.org/10.1590/S1807-59322009001200005
work_keys_str_mv AT dasilvadafnecardosobourguignon howismechanicalventilationemployedinapediatricintensivecareunitinbrazil
AT shibataaudreyrieogawa howismechanicalventilationemployedinapediatricintensivecareunitinbrazil
AT fariasjulioa howismechanicalventilationemployedinapediatricintensivecareunitinbrazil
AT trostereduardojuan howismechanicalventilationemployedinapediatricintensivecareunitinbrazil