Incidência, causas e desfechos da extubação não planejada em uma Unidade de Terapia Intensiva Pediátrica

Abstract

The aim of this study was to describe and analyze the incidence, causes, procedures associated with unplanned extubation (UPE) and outcomes in children admitted to a Pediatric Intensive Care Unit (PICU). A retrospective cohort study was conducted, in which data on UPE were collected through a clinical indicators form during the period from 2019 to 2021, at the Hospital de Clínicas of the Federal University of Uberlândia. Descriptive and inferential data analysis was performed. The sample consisted of 26 participants with UPE, where three of them had more than one episode, resulting in 29 UPE. The incidence of UPE was 0.99/100 days of intubation and the prevalence 6.3%. The main cause of UPE was agitation (p<0.0001), in patients with a clinical diagnosis at admission (p=0.030) and who had not planned extubation (13.8%) (p=0.005). 15 UPE (51.7%) were not related to procedures and 14 patients (48.3%) were not reintubated compared to those reintubated within 48h, with or without non-invasive ventilation (13.8%) (p= 0.046). The absence of continuous sedation was significantly related to non-reintubation. There was no significant difference in UPE in relation to sex, age, duration of mechanical ventilation, age group, use of endotracheal tube with cuff, period and use of continuous sedation. It is concluded that the incidence was below the recommended level, occurring mainly due to agitation, more frequently in preschoolers, who had not planned extubation, with continuous sedation and the main outcome was reintubation.