Paulo Sérgio Lucas da Silva1, Vânia Euzébio de Aguiar2, Marcelo Cunio Machado Fonseca3. 1. Department of Pediatrics, Pediatric Intensive Care Unit, Hospital do Servidor Público Municipal, Rua Castro Alves, 60, São Paulo 01532-900, Brazil. Electronic address: psls.nat@terra.com.br. 2. Department of Pediatrics, Pediatric Intensive Care Unit, Hospital do Servidor Público Municipal, Rua Castro Alves, 60, São Paulo 01532-900, Brazil. 3. Department of Pediatrics, Pediatric Intensive Care Unit, Universidade Federal de São Paulo, Brazil.
Abstract
OBJECTIVES: Determine prevalence, risk factors and outcomes of iatrogenic pneumothoraces (IPs) in a pediatric intensive care unit (PICU). METHODS: Patients with IP (cases) and patients without IP (controls) were retrieved from a 5-year prospective cohort of 645 PICU patients who received mechanical ventilation (MV). RESULTS: Twenty cases and eighty controls were assessed. The overall prevalence of IP was 3%. Eleven IPs were procedure-related IP and 9 MV related. Performance of thoracic invasive procedures (odds ratio 11) was the significant IP predictor in the logistic regression analysis. IP incidence was higher within 12 hours. There were no differences between the groups concerning duration of MV, length of PICU and hospital stays. IP patients had a significantly higher mortality rate (p = 0.005). CONCLUSIONS: Performance of thoracic invasive procedures was strongly associated with IPs events in mechanically ventilated children. Many of these events may potentially be preventable with the implementation of quality improvement programs.
OBJECTIVES: Determine prevalence, risk factors and outcomes of iatrogenic pneumothoraces (IPs) in a pediatric intensive care unit (PICU). METHODS:Patients with IP (cases) and patients without IP (controls) were retrieved from a 5-year prospective cohort of 645 PICU patients who received mechanical ventilation (MV). RESULTS: Twenty cases and eighty controls were assessed. The overall prevalence of IP was 3%. Eleven IPs were procedure-related IP and 9 MV related. Performance of thoracic invasive procedures (odds ratio 11) was the significant IP predictor in the logistic regression analysis. IP incidence was higher within 12 hours. There were no differences between the groups concerning duration of MV, length of PICU and hospital stays. IP patients had a significantly higher mortality rate (p = 0.005). CONCLUSIONS: Performance of thoracic invasive procedures was strongly associated with IPs events in mechanically ventilated children. Many of these events may potentially be preventable with the implementation of quality improvement programs.