Incidence and Risk Factors for Cardiovascular Collapse After Unplanned Extubations in the Pediatric ICU
dc.citation.issue | 7 | ] |
dc.citation.volume | 62 | ] |
dc.contributor.author | Lucas da Silva, Paulo Sergio | |
dc.contributor.author | Machado Fonseca, Marcelo Cunio [UNIFESP] | |
dc.coverage | Irving | |
dc.date.accessioned | 2020-06-26T16:30:32Z | |
dc.date.available | 2020-06-26T16:30:32Z | |
dc.date.issued | 2017 | |
dc.description.abstract | BACKGROUND: Cardiovascular collapse is a life-threatening event after unplanned extubations (UEs) in the pediatric ICU (PICU). However, there is a paucity of pediatric studies assessing this complication. We sought to assess the incidence, risk factors, and outcome of cardiovascular collapse after UEs in PICU patients. METHODS: All children who had been mechanically ventilated for >= 12 h were prospectively tracked for UEs over an 8-y period. Subjects were included in the study if they were between ages 1 month and 16 y and had experienced UE. They were analyzed in 2 groups: those with cardiovascular collapse (defined as the need for cardiopulmonary resuscitation or circulatory dysfunction immediately after UE) and those with no cardiovascular collapse. RESULTS: Of the 847 subjects, 109 UEs occurred in 14,293 intubation days (0.76 UEs/100 intubation days), with 21 subjects (19.2%) experiencing cardiovascular collapse, of which 10 required cardiopulmonary resuscitation. Compared with subjects without cardiovascular collapse after UE, children with cardiovascular collapse were younger(<6 months old), with respiratory failure from lower respiratory tract diseases, lower P-aO2/F-IO2 (218 vs 282 mm Hg), and higher oxygenation indices (5.5 vs 3.5) before UE events. Logistic regression revealed that only an age <6 months old was strongly associated with cardiovascular collapse (odds ratio 3.4, P = .03). There were no differences between cardiovascular collapse and non-cardiovascular collapse subjects regarding the length of hospital stay, ventilator-associated pneumonia rate, and mortality. CONCLUSIONS: Cardiovascular collapse is a frequent complication of UEs, particularly in the youngest children. Specific bundles to prevent UEs may reduce morbidity related to these events. | en |
dc.description.affiliation | Hosp Servidor Publ Municipal, Dept Pediat, Pediat Intens Care Unit, Rua Castro Alves 60, BR-01532900 Sao Paulo, Brazil | |
dc.description.affiliation | Fed Univ Sao Paulo UNIFESP, Hlth Technol Assessment Unit, Sao Paulo, Brazil | |
dc.description.affiliationUnifesp | Fed Univ Sao Paulo UNIFESP, Hlth Technol Assessment Unit, Sao Paulo, Brazil | |
dc.description.source | Web of Science | |
dc.format.extent | 896-903 | |
dc.identifier | http://dx.doi.org/10.4187/respcare.05346 | ] |
dc.identifier.citation | Respiratory Care. Irving, v. 62, n. 7, p. 896-903, 2017. | |
dc.identifier.doi | 10.4187/respcare.05346 | |
dc.identifier.file | WOS000404102600006.pdf | |
dc.identifier.issn | 0020-1324 | |
dc.identifier.uri | https://repositorio.unifesp.br/handle/11600/53607 | |
dc.identifier.wos | WOS:000404102600006 | |
dc.language.iso | eng | |
dc.publisher | Daedalus Enterprises Inc | |
dc.relation.ispartof | Respiratory Care | |
dc.rights | ACESSO ABERTO | |
dc.subject | complications | en |
dc.subject | endotracheal extubation | en |
dc.subject | outcomes | en |
dc.subject | pediatric intensive care unit | en |
dc.subject | unplanned extubation | en |
dc.title | Incidence and Risk Factors for Cardiovascular Collapse After Unplanned Extubations in the Pediatric ICU | en |
dc.type | Artigo |
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