Resumen

HUBER BAUR, Ana Maria; FUENMAYOR, Akbar; SALGAR, Nilce  y  GOTTBERG, Esther. Risk factors for unplanned extubation and reintubation in children. Arch Venez Puer Ped [online]. 2013, vol.76, n.1, pp.17-23. ISSN 0004-0649.

Unplanned extubation (UEX) and reintubation are adverse events related with medical care, which can produce complications, could be prevented and are considered health quality indicators in critical care. Objectives: To determine the frequency, risk factors and results of UEX and reintubation in hospitalized children in the Instituto Autónomo Hospital Universitario de Los Andes from July 2010-July 2011. Methods: This was an observational, clinical, prospective and concurrent study in children who were extubated. Demographic and clinical features were analyzed and their evolution was followed. Statistical analysis was performed with SPSS-12.0. Results: 76 patients were included, average age was 6, 43 years (1 month to 15 years, SD ± 6,04). The main diagnoses were infections and trauma. 37,2% of the patients were intubated because of respiratory insufficiency. 27, 3% of the extubations were unplanned (accidental 19,7%, autoextubation 7,98%). Most of the patients were on assisted ventilation (AV), controlled ventilator mode before the extubation. The UEX was more frequent in younger children, with uncuffed tubes, administration of neuromuscular blockers and sedative therapy, agitation and Glasgow below 9 points. Reintubation was associated with UEX, sedative drugs and neuromuscular blockers, no steroids or bronchodilators, no weaning, agitation and Glasgow below 9 points. The UEX and reintubations prolonged the AV time. Conclusion: There are risk factors which can be recognized in patients with UEX and reintubations, for which reason it is important to develop strategies to prevent these adverse events.

Palabras clave : unplanned extubation; reintubation; adverse events.

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