Avaliação funcional de crianças internadas em unidade de terapia intensiva pediátrica até a alta hospitalar de um hospital universitário

Abstract

Introduction: The increase in survival of complex patients with complex needs to Pediatric Intensive Care Units (PICUs) has generated prolonged hospitalizations, negatively affecting the functional capacity of children after discharge. Objective: To evaluate the functional status of pediatric patients prior to their admission to a PICU and at the time of hospital discharge, using a functional scale. Methods: This is a retrospective observational cohort study, in which patient data were collected from the institution's medical records and information on their functional status through the Functional Status Scale (FSS), developed for hospitalized children. The FSS was applied at ICU admission, considering the patient's functional status prior to admission, and at the time of hospital discharge. Results: 24 (68.6%) patients maintained the functionality of admission at the time of hospital discharge and the majority (91.4%) did not acquire new morbidity during hospitalization. The duration of IMV and sedation time increase the chance of the patient presenting mild (p=0.027; p=0.007, respectively) and severe (p=0.022; p=0.013, respectively) dysfunction in relation to normal functionality. Only motor status showed a significant association with worsening of functional status at hospital discharge (p=0.001). Conclusion: Most children did not present a decline in functional status and maintained adequate functional status. Furthermore, sedation time and IMV time are the main factors associated with changes in patient functionality, with the motor status domain of the FSS being the most affected.