Características, mortalidade e custos de pacientes pediátricos em ventilação mecânica prolongada em três UTI pediátricas de Porto Alegre

• Ano de defesa: 2007
• Autor(a) principal: Traiber, Cristiane
• Orientador(a): Fritscher, Carlos Cezar
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre
• Palavras-chave em Português: MEDICINA; PEDIATRIA; UNIDADES DE TERAPIA INTENSIVA PEDIÁTRICA; ANÁLISE CUSTO-BENEFÍCIO; RESPIRAÇÃO ARTIFICIAL; MORTALIDADE INFANTIL
• Link de acesso: http://hdl.handle.net/10923/4684

Objective: to describe the characteristics of pediatric patients submitted to prolonged mechanical ventilation (MV), evaluate the mortality and associated factors as well as the costs of the pediatric intensive care unit (PICU) admission. Methods: a retrospective study that includes all children admitted to 3 PICU between January 2003 and December 2005 submitted to MV > 21 days. The patients were evaluated until the discharge from the PICU, including anthropometrics data, diagnostics, ventilator parameters on the 21st day, length of MV, length of stay in PICU, costs and mortality. The 3 selected PICU were university affiliated hospitals of tertiary level and regional reference. Results:A total of 184 patients (190 admission) submitted to MV for 21 days or more, in 3 different PICU, were analyses in this study. The median of weight was 5. 5 kg and the median age was 6 months, 85 % had chronic co-morbidity. The average time on MV was 60 days with a mortality rate of 48%. Tracheostomy was performed in 37 children (19%). On the 21st day of MV the factors associated to mortality were: Positive inspiratory pressure > 25 cmH2O (OR =2,3; 1,1-5,1), Inspired Oxygen fraction > 0,5 (OR=6,3; 2,2-18,1) and vasoactive drugs infusion (OR=2,6;1,1-5,9). The average cost was RS 754,00 (USD 359) per patient per day. Conclusions: Pediatric patients submitted to prolonged MV presented high mortality rate as well as high social and economical cost. The mortality rate was associated to higher ventilatory parameters and vasoactive drug support on the 21st day of MV in this group of patients.