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You searched for:"Renata de Carvalho Schettino"

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  • Artigos Originais - Pesquisa Clínica

    Incidence and primary causes of unplanned extubation in a neonatal intensive care unit

    Revista Brasileira de Terapia Intensiva. 2012;24(3):230-235

    Abstract

    Artigos Originais - Pesquisa Clínica

    Incidence and primary causes of unplanned extubation in a neonatal intensive care unit

    Revista Brasileira de Terapia Intensiva. 2012;24(3):230-235

    DOI 10.1590/S0103-507X2012000300005

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    OBJECTIVE: This study established the incidence and primary causes of unplanned extubation in newborns in the neonatal intensive care units of the Hospital Sofia Feldman, Belo Horizonte (Minas Gerais). METHODS: This retrospective study was conducted between July 1, 2009 and April 30, 2010. Unplanned extubations and their primary causes were assessed using an adverse events form. The following variables were assessed: gender, corrected age, present weight, duration of mechanical ventilation time, and motives/causes of the event on the day of the unplanned extubation event. RESULTS: Fifty-four unplanned extubations occurred, which corresponded to an incidence of 1.0 event/100 days of mechanical ventilation. This rate was higher among newborns with a corrected age of 30 to 36 weeks and weight < 1,000 g. The primary causes of unplanned extubations included patient agitation, inappropriate handling of patients during the performance of procedures, and inappropriate fixation and positioning of the endotracheal tube. CONCLUSION: The incidence of unplanned extubation in the investigated neonatal intensive care units was low during the study period compared to previously reported data. Nevertheless, the assessment of the quality of procedures, the continuous follow-up of newborns, and the monitoring of the causes of extubation are required to further reduce this incidence.

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  • ORIGINAL ARTICLES

    Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation

    Revista brasileira de terapia intensiva. 2014;26(1):51-56

    Abstract

    ORIGINAL ARTICLES

    Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation

    Revista brasileira de terapia intensiva. 2014;26(1):51-56

    DOI 10.5935/0103-507X.20140008

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    Objective:

    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.

    Methods:

    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.

    Results:

    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.

    Conclusion:

    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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