Pediatric ventilation weaning

Lourenção, Murilo Lopes; Carvalho, Werther Brunow de

doi:10.5935/0103-507x.20200061

Cited by 2 publications

(1 citation statement)

References 33 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Duration of mechanical ventilation is very much related to the indication and rate of improvement of the ventilated child (20). Antibiotics, fluids and management of other system affection are all crucial factors in reducing the MV duration and procuring the better extubation.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Failed Extubation in Mechanically Ventilated Children: Single Center Experience

Ishak

Mohamed²,

El-Sherbini³

et al. 2022

Pediatric Sciences Journal

View full text Add to dashboard Cite

Background: Extubation failure is failure to maintain normal spontaneous breathing after a period of mechanical ventilation with the need for reintubation within 24-72 hours. It has multiple risk factors such as deconditioned muscles, upper airway edema and others. Aim of the Work:To study the frequency and causes of extubation failure in mechanically ventilated children. Patients and Methods: This is an observational prospective study that included all admitted children in Pediatric Intensive Care Unit (PICU), Cairo University Children Hospital who underwent mechanical ventilation (MV) through endotracheal tube for more than 48 hours (145 child) with Glasgow coma scale above 8. They were subdivided into successfully extubated (78 children) and failed extubation (67 children). Results:The mean ± SD age of the cohort was 13.5 ± 15.15 months (range1.3-48, median= 8 months). Of them 80 (55.17%) were males, and 65 (44.8%) were females. The commonest underlying diagnosis was pneumonia in 38 (26.2%), bronchial asthma in 32 (22%), encephalopathy in 32 (22%), and aspiration in 11 (7.58%). Failed extubation was encountered in 67 (46.2%) children. The encountered risk factors of extubation failure were: sedation in 12 (16.7%) (p=0.001), excessive tracheal secretion of more than 200 ml /24 h in 14 (18.7%) (p=0.03), accidental extubation in 27 (40.3%) (p=0.01) and the need for higher setting on MV in all 67 children with failed extubation. Among failed extubated patients, the mean± SD for peak inspiratory pressure (PIP), positive end-expiratory pressure (PEEP), and fraction of inspired oxygen (FiO2) were 14.5± 1.8 /cm H2O, 5.5± 0.5/cm H2O, and 27.5± 6.1% respectively. While, PIP, PEEP, and FiO2 in the successfully extubated group were 12.8± 1.6 /cm H2O, 4.1± 0.4/cm H2O, and 24.8± 5.3%, (p= 0.01, p=0.001 and p= 0.001) respectively. Patients who underwent gradual withdrawal of ventilatory support had a higher frequency of successful extubation than those extubated accidentally (p= 0.01). Sensitivity, and specificity of above mentioned indices for successful extubation were 53.79%, and 28.72% respectively. Conclusion: Causes of extubation failure are the need for long duration of sedation, excessive tracheal secretion, and need for high setting on MV. Furthermore, gradual weaning decreases the frequency of extubation failure. There is a need for a more sensitive and specific comprehensive objective indicator(s) for successful timely extubation.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictors of Failed Extubation in Mechanically Ventilated Children: Single Center Experience

Ishak

Mohamed²,

El-Sherbini³

et al. 2022

Pediatric Sciences Journal

View full text Add to dashboard Cite

show abstract

Análise da qualidade da assistência fisioterapêutica por meio de indicadores assistenciais em saúde em uma unidade de terapia intensiva pediátrica da região norte

Sesquim cardoso

2024

rsc

View full text Add to dashboard Cite

Os indicadores de saúde são medidas que refletem indiretamente nas informações relevantes em diferentes dimensões e atributos da saúde e fatores que afetam a saúde incluindo o desempenho do sistema de saúde, a tendência e que os profissionais de saúde enfrentem uma demanda crescente para fornecer cuidados seguros, eficientes e de alta qualidade, utilizando métodos consistentes e eficientes para analisar os dados epidemiológicos sobre morbimortalidade. Em uma unidade terapia intensiva pediátrica conhecer as variáveis desses indicadores permite que decisões estratégicas sejam tomadas para melhoraria da qualidade no atendimento e serviço oferecido. De acordo com a Resolução COFFITO n° 402/2011,o profissional fisioterapeuta desenvolve técnicas e recursos relacionados à manutenção da permeabilidade de vias aéreas; a realização de procedimentos relacionados à via aérea artificial; a participação no processo de instituição e gerenciamento da Ventilação Mecânica (VM); melhora da interação entre o paciente e o suporte ventilatório; condução dos protocolos de desmame da VM, incluindo a extubação; implementação do suporte ventilatório não invasivo; gerenciamento da aerossolterapia e oxigenoterapia; mobilização do doente crítico. Essa gama de recursos refletem diretamente nos resultados dos indicadores Qualidade em Assistência à Saúde, de acordo com as recomendações da INSTRUÇÃO NORMATIVA No 4, DE 24 DE FEVEREIRO DE 2010, relacionados a Tempo de permanência na Unidade de Terapia Intensiva, Taxa de utilização de Ventilação Mecânica (VM),Incidência de Pneumonia Associada à Ventilação Mecânica (PAV).

show abstract

Pediatric ventilation weaning

Cited by 2 publications

References 33 publications

Predictors of Failed Extubation in Mechanically Ventilated Children: Single Center Experience

Predictors of Failed Extubation in Mechanically Ventilated Children: Single Center Experience

Análise da qualidade da assistência fisioterapêutica por meio de indicadores assistenciais em saúde em uma unidade de terapia intensiva pediátrica da região norte

Contact Info

Product

Resources

About