Abstract
Rev Bras Ter Intensiva. 2022;34(4):469-476
DOI 10.5935/0103-507X.20220429-en
To evaluate the effects of critical illness on the functional status of children aged zero to 4 years with or without a history of prematurity after discharge from the pediatric intensive care unit.
This was a secondary cross-sectional study nested in an observational cohort of survivors from a pediatric intensive care unit. Functional assessment was performed using the Functional Status Scale within 48 hours after discharge from the pediatric intensive care unit.
A total of 126 patients participated in the study, 75 of whom were premature, and 51 of whom were born at term. Comparing the baseline and functional status at pediatric intensive care unit discharge, both groups showed significant differences (p < 0.001). Preterm patients exhibited greater functional decline at discharge from the pediatric intensive care unit (61%). Among patients born at term, there was a significant correlation between the Pediatric Index of Mortality, duration of sedation, duration of mechanical ventilation and length of hospital stay with the functional outcomes (p = 0.05).
Most patients showed a functional decline at discharge from the pediatric intensive care unit. Although preterm patients had a greater functional decline at discharge, sedation and mechanical ventilation duration influenced functional status among patients born at term.
Abstract
Rev Bras Ter Intensiva. 2022;34(2):247-254
DOI 10.5935/0103-507X.20220022-en
To investigate the association between noninvasive ventilation delivery devices and the incidence of nasal septum injury in preterm infants.
This retrospective singlecenter cohort study included preterm infants supported by noninvasive ventilation. The incidence of nasal injury was compared among three groups according to the noninvasive ventilation delivery device (G1 - nasal mask; G2 - binasal prongs; and G3, rotation of nasal mask with prongs). Nasal injury was classified according to the National Pressure Ulcer Advisory Panel as stages 1 - 4. Multivariate regression analyses were performed to estimate relative risks to identify possible predictors associated with medical device-related injuries.
Among the 300 infants included in the study, the incidence of medical device-related injuries in the rotating group was significantly lower than that in the continuous mask or prong groups (n = 68; 40.48%; p value < 0.01).
Rotating nasal masks with nasal prongs reduces the incidence of moderate to severe nasal injury in comparison with single devices. The addition of days using noninvasive ventilation seems to contribute to medical device-related injuries, and higher birth weight is a protective factor.
Abstract
Rev Bras Ter Intensiva. 2014;26(1):51-56
DOI 10.5935/0103-507X.20140008
To identify risk factors for extubation failure and reintubation in newborn infants subjected to mechanical ventilation and to establish whether ventilation parameters and blood gas analysis behave as predictors of those outcomes.
Prospective study conducted at a neonatal intensive care unit from May to November 2011. A total of 176 infants of both genders subjected to mechanical ventilation were assessed after extubation. Extubation failure was defined as the need to resume mechanical ventilation within less than 72 hours. Reintubation was defined as the need to reintubate the infants any time after the first 72 hours.
Based on the univariate analysis, the variables gestational age <28 weeks, birth weight <1,000g and low Apgar scores were associated with extubation failure and reintubation. Based on the multivariate analysis, the variables length of mechanical ventilation (days), potential of hydrogen (pH) and partial pressure of oxygen (pO2) remained associated with extubation failure, and the five-minute Apgar score and age at extubation were associated with reintubation.
Low five-minute Apgar scores, age at extubation, length of mechanical ventilation, acid-base disorders and hyperoxia exhibited associations with the investigated outcomes of extubation failure and reintubation.
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