Article Text

CURRENT PRACTICES OF MECHANICAL VENTILATION IN NEONATAL AND PEDIATRIC INTENSIVE CARE UNITS IN SOUTHEAST BRAZIL
  1. V C Soares1,
  2. A P Barbosa2,
  3. A J L A Cunha2,
  4. C T L C Vanzillotta1,
  5. E A Diniz1,
  6. J C Lacerda1,
  7. S D Gama1
  1. 1PICU, Instituto de Puericultura E Pediatria Martagao Gesteira, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
  2. 2Department of Pediatrics, School of Medicine, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, RJ, Brazil

Abstract

Objective To describe how mechanical ventilation (MV) is employed in neonatal and pediatric intensive care units in the southeast of Brazil (Rio de Janeiro).

Methods Cross-sectional study of all patients on MV at the day of the visit to the unit (January 2007 to March 2008).

Results Of the 100 existing units, 51 were studied (22 NICU, 17 PICU, 12 mixed). Of the 314 admitted patients, 71 (22%) were on MV (16% in NICUs, 63.5% in PICUs and 11.3% in mixed units). In NICUs 64% were female and in PICUs 42%. In PICUs and mixed units, 10% were newborns, 51% infants, 23% pre-schoolers, 9% schoolers and 7% adolescents. The median time of MV was 8.2 days (0–26), excluding 16 patients on chronic MV (>30 days). Only 3 patients (newborns) were on non-invasive MV. The main indications for invasive MV were sepsis and pneumonia in children, followed by neurological diseases and respiratory distress syndrome in newborns. Most had an oral endotracheal tube without cuff (tracheotomy rarely used in older children). Non-synchronized intermittent mandatory ventilation (IMV) was the most used ventilatory mode, followed by SIMV with pressure support. The complication rate was 25% (18 patients) and the main complication was pneumonia.

Conclusion In most units traditional IMV is still the most used way to ventilate children, although other modes are available. The knowledge of current practices may become an important tool to aid in educational programs to improve the practice of MV in neonatal and pediatric intensive care in our country.

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