RESUMO
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Assuntos
Feminino , Humanos , Masculino , Ventilação não Invasiva/métodos , Estágio Clínico/ética , Bronquite Crônica/metabolismo , Bronquite Crônica/patologia , Cuidados Críticos/métodos , Ventilação não Invasiva/instrumentação , Estágio Clínico , Bronquite Crônica/complicações , Bronquite Crônica/diagnóstico , Cuidados Críticos/normas , Estudo ObservacionalRESUMO
OBJETIVOS: Estudiar la evolución durante 12 años del uso de la ventilación mecánica invasiva (VMI) y no invasiva (VNI) en niños con bronquiolitis ingresados en una unidad de cuidados intensivos pediátricos (UCIP). PACIENTES Y MÉTODOS: Estudio retrospectivo observacional de 12 años de duración (2001-2012) en el que se incluyó a todos los niños ingresados con bronquiolitis en UCIP que requirieron VMI y/o VNI. Se analizaron las características demográficas, el tipo de asistencia respiratoria y la evolución clínica, comparándose los primeros 6 años de estudio con los segundos. RESULTADOS: Se estudió a 196 pacientes. Un 30,1% requirió VMI y un 93,3% VNI. La mediana de duración de VMI fue de 9,5 días y la de VNI de 3 días. La duración de ingreso en UCIP fue de 7 días y falleció un 2% de los pacientes. La utilización de VNI aumentó del 79,4% en el primer periodo al 100% en el segundo periodo (p < 0,0001) y disminuyó el de VMI del 46% en el primer periodo al 22,6% en el segundo (p < 0,0001). La presión positiva continua en la vía aérea y el tubo endotraqueal cortado fueron la modalidad y la interfase más utilizadas, aunque en el segundo periodo aumentó significativamente el uso de ventilación con 2 niveles de presión (p < 0,0001) y de púas nasales (p < 0,0001), y disminuyó la duración de ingreso en la UCIP (p = 0,011). CONCLUSIONES: La mayor utilización de VNI en pacientes con bronquiolitis en nuestra unidad en los últimos años se asoció a una disminución de la necesidad de VMI y de la duración del ingreso en la UCIP
OBJECTIVES: The aim of the study was to analyse the evolution, over a12-year period, of the use of non-invasive (NIV) and invasive ventilation (IV) in children admitted to a Paediatric Intensive Care Unit (PICU) due to acute bronchiolitis. PATIENTS AND METHODS: A retrospective observational study was performed including all children who were admitted to the PICU requiring NIV or IV between 2001 and 2012. Demographic characteristics, ventilation assistance and clinical outcome were analysed. A comparison was made between the first six years and the last 6 years of the study. RESULTS: A total of 196 children were included; 30.1% of the subjects required IV and 93.3% required NIV. The median duration of IV was 9.5 days and NIV duration was 3 days. The median PICU length of stay was 7 days, and 2% of the patients died. The use of NIV increased from 79.4% in first period to 100% in the second period (P<.0001) and IV use decreased from 46% in the first period to 22.6% in the last 6 years (P<.0001). Continuous positive airway pressure and nasopharyngeal tube were the most frequently used modality and interface, although the use of bi-level non-invasive ventilation (P<.001) and of nasal cannulas significantly increased(P<.0001) in the second period, and the PICU length of stay was shorter (P=.011). CONCLUSION: The increasing use of NIV in bronchiolitis in our PICU during the last 12 years was associated with a decrease in the use of IV and length of stay in the PICU
Assuntos
Criança , Feminino , Humanos , Masculino , Respiração Artificial/métodos , Respiração Artificial , Bronquiolite/complicações , Bronquiolite/diagnóstico , Bronquiolite/terapia , Pressão Positiva Contínua nas Vias Aéreas/métodos , Pressão Positiva Contínua nas Vias Aéreas , Ventilação de Alta Frequência/métodos , Respiração com Pressão Positiva Intermitente/métodos , Ventilação com Pressão Positiva IntermitenteRESUMO
OBJECTIVES: The aim of the study was to analyse the evolution, over a12-year period, of the use of non-invasive (NIV) and invasive ventilation (IV) in children admitted to a Paediatric Intensive Care Unit (PICU) due to acute bronchiolitis. PATIENTS AND METHODS: A retrospective observational study was performed including all children who were admitted to the PICU requiring NIV or IV between 2001 and 2012. Demographic characteristics, ventilation assistance and clinical outcome were analysed. A comparison was made between the first six years and the last 6 years of the study. RESULTS: A total of 196 children were included; 30.1% of the subjects required IV and 93.3% required NIV. The median duration of IV was 9.5 days and NIV duration was 3 days. The median PICU length of stay was 7 days, and 2% of the patients died. The use of NIV increased from 79.4% in first period to 100% in the second period (P<.0001) and IV use decreased from 46% in first period to 22.6% in the last 6 years (P<.0001). Continuous positive airway pressure and nasopharyngeal tube were the most frequently used modality and interface, although the use of bi-level non-invasive ventilation (P<.001) and of nasal cannulas significantly increased (P<.0001) in the second period, and the PICU length of stay was shorter (P=.011). CONCLUSION: The increasing use of NIV in bronchiolitis in our PICU during the last 12 years was associated with a decrease in the use of IV and length of stay in the PICU.
Assuntos
Bronquiolite/terapia , Ventilação não Invasiva/tendências , Doença Aguda , Feminino , Humanos , Lactente , Masculino , Ventilação não Invasiva/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos , Respiração Artificial/tendências , Estudos Retrospectivos , Fatores de TempoRESUMO
Presentamos el caso de un varón de 14 años, diagnosticado de histiocitosis de células de Langerhans a los 16 meses de edad, en el que, sin presentar patología respiratoria evidente, se aprecia un patrón multiquístico bilateral en la tomografía computarizada de tórax, y un patrón intersticial bilateral en la radiografía convencional. Atendiendo a las características radiológicas del paciente, proponemos el diagnóstico diferencial de entidades infrecuentes que cursan con expresión multiquística pulmonar en la edad pediátrica (AU)
We report that a 14-year-old teen who was diagnosed with Langerhans cell histiocytosis at 16 months of age and with no previous respiratory symptoms, shows a bilateral multicystic pattern in thoracic computed tomography and bilateral interstitial infiltrates in chest radiography. Taking into account the radiologic features we propose the differential diagnosis of disorders with multiple cystic pulmonary findings in children (AU)
Assuntos
Humanos , Masculino , Adolescente , Cistos/diagnóstico , Pneumopatias/diagnóstico , Histiocitose de Células de Langerhans/diagnóstico , Diagnóstico Diferencial , Infecções por Pneumocystis/diagnóstico , Pneumocystis carinii/isolamento & purificação , Doenças Pulmonares Intersticiais/diagnósticoRESUMO
No disponible
Assuntos
Humanos , Masculino , Lactente , Medicamento Homeopático , /diagnóstico , Informação de Saúde ao Consumidor , Uso Indevido de Medicamentos sob PrescriçãoRESUMO
No disponible
