Pediatric Intensive Care Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Rev Paul Pediatr. 2021;39:e2019180. doi: 10.1590/1984-0462/2021/39/2019180. Epub 2020 Aug 26.
To identify the prevalence and factors associated with adverse events (AE) related to invasive mechanical ventilation in patients admitted to the Pediatric Intensive Care Unit (PICU) of a tertiary public hospital.
This is a cross-sectional study from July 2016 to June 2018, with data collected throughout patients' routine care in the unit by the care team. Demographic, clinical and ventilatory characteristics and adverse events were analysed. The logistic regression model was used for multivariate analysis regarding the factors associated with AE.
Three hundred and six patients were included, with a total ventilation time of 2,155 days. Adverse events occurred in 66 patients (21.6%), and in 11 of those (16.7%) two AE occurred, totalling 77 events (36 AE per 1000 days of ventilation). The most common AE was post-extubation stridor (25.9%), followed by unplanned extubation (16.9%). Episodes occurred predominantly in the afternoon shift (49.3%) and associated with mild damage (54.6%). Multivariate analysis showed a higher occurrence of AE associated with length of stay of 7 days or more (Odds Ratio [OR]=2.6; 95% confidence interval [95%CI] 1.49-4.66; p=0.001).
The results of the present study show a significant number of preventable adverse events, especially stridor after extubation and accidental extubation. The higher frequency of these events is associated with longer hospitalization.
确定在一家三级公立医院的儿科重症监护病房（PICU）住院的患者接受有创机械通气相关不良事件（AE）的发生率和相关因素。
这是一项 2016 年 7 月至 2018 年 6 月的横断面研究，数据由护理团队在该单元患者常规护理期间收集。分析了人口统计学、临床和通气特征以及不良事件。使用逻辑回归模型对与 AE 相关的因素进行多变量分析。
共纳入 306 名患者，总通气时间为 2155 天。66 名患者（21.6%）发生了不良事件，其中 11 名（16.7%）发生了 2 次 AE，共发生了 77 次事件（每 1000 天通气发生 36 次 AE）。最常见的 AE 是拔管后喘鸣（25.9%），其次是计划外拔管（16.9%）。发作主要发生在下午班（49.3%），并与轻度损伤有关（54.6%）。多变量分析显示，AE 的发生与住院时间为 7 天或以上有关（优势比[OR]=2.6；95%置信区间[95%CI]1.49-4.66；p=0.001）。
本研究结果显示，有相当数量的可预防不良事件，特别是拔管后喘鸣和意外拔管。这些事件的发生频率较高与住院时间较长有关。
