SOBREVIDA AL PARO CARDIORESPIRATORIO EN LA UNIDAD DE MEDICINA CRÍTICA PEDIÁTRICA
Abstract
La sobrevida de los pacientes ingresados en una Unidad Terapia Intensiva Pediátrica (UCIP) que sufren un evento de paro cardiorespiratorio (PCR) varía en la literatura de un 6% a 64%. Este estudio busca conocer la sobrevida de los pacientes que presentan un evento de PCR durante su estancia en la UCIP de un hospital público terciario, las características demográficas y factores asociados a estos eventos. Estudio observacional, descriptivo, retrospectivo y transversal. Se revisaron los expedientes de pacientes ingresados en UCIP, durante un año, que presentaran PCR obteniendo las siguientes variables: edad, género, días de estancia, tiempo del ingreso al primer PCR, diagnóstico de base, número de PCR por paciente, RCP básico o avanzado, causa directa del PCR, tiempo transcurrido entre cada uno de los eventos de PCR, el turno, PCR previos al ingreso, uso de aminas, PRISM-12 y 24, evolución a muerte o sobrevida. 41 pacientes, 74 eventos de PCR, incidencia de PCR 28.8 por 100 admisiones, sobrevida general 80.7%, sobrevida al evento de PCR 48.6%. Estancia 7.4 días ± 10.6, 5.4 días del ingreso al PCR, edad media 51 meses, predominio de lactantes, masculinos, diagnóstico de ingreso Neurológico, causa del PCR problemas Respiratorios, PCR único, 60.8% uso de aminas, 94.5% RCP avanzado, PRISM-24 17.4 ± 7.9. Los factores de mal pronóstico fueron, menos días de estancia, primer PCR en las primeras 24 horas del ingreso, presentar nuevo PCR a menos de 24 horas del anterior, y requerir RCP avanzado.
Abstract
The Overlife of the pacients admitted in a Pediatric Intensive Care Unit (PICU) that suffer an event of cardiacrespiratory heart failure (PCR) changes on the literature from 6% to 64%. This study aims to know the overlife of the pacients that presents an event of PCR during their homesick in the PICU of a tertiary public hospital, the demographic characteristic and factors associated to this events. Observational, descriptive, retrospective and transversal study. The expedients of the pacients admitted on PICU of that year, that presents PCR obtained from the next variables: age, gender, staying days, first admitted PCR date , base diagnostic, number of PCR per pacient, básic or advanced RCP, PCR direct cause, tiem passed from each PCR event, turn, previus PCR events before admitted, aminas use, PRISM-12 and 24, death o overlife evolution. 41 pacients, 74 PCR events, 28.8 per 100 PCR admitted incidence, 80.7% general overlife, 48.6% PCR event overlife. 7.4 días ± 10.6 staying days, 5.4 days of PCR admitted pacient, 51 months medium age, lactantcy predominance, males, Neurológic admitted diagnostic, respiratory problems cause of the PCR, unique PCR, aminas use 60.8% , 94.5% advanced RCP , PRISM-24 17.4 ± 7.9. The bad pronostic factors were, less staying days, first PCR in first 24 hours admitted, to show new PCR in less than 24 hours of previuos PCR, and require advenced RCP.
Palabras clave: UCIP, Paro cardiorespiratorio, sobrevida, PICU (UCIP), cardiac-respiratory heart failure.
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References
De Moss, N., R.L. Raphaele, B McCrindle, D.J. Bohn, Ch.S. Parshuram. 2006. Pediatric in-intensive-care-unit cardiac arrest: Incidense, survival, and predictive factors. Critical Care Med. Vol.34. No 4: 1209-15.
Hazinski, F.M. and A. Zaritsky. 2003. AVAP Manual para proveedores. American Heart Association. Editorial Manual Moderno. 3ra. Edición. Cap 2-3. pp 23-80.
Berrueta, M. y A. Saporiti, 2000. Consenso de Reanimación Cardiopulmonar Pediátrica. Arch. Argent. Pediatr; Cap.98 No.4: pp258-276.
Idem.
Garza, A. y R. Vallejo. 2003. Reanimación Cardiopulmonar {G. Treviño Martínez}. Manual de Pediatría. 1º Edición. México DF: McGraw Hill Interamericana. Cap.99. pp 861-80.
Parra, D.A.,B.R. Totapally, E. Zahn, J. Jacobs, A. Aldousany, R.P. Burke and A.C. Chang. 2000. Outcome of cardiopulmonary resuscitation in a pediatric cardiac intensive care unit. Crit Care Med. Cap.28 No.9: pp3296- 300.
Hazinski, F.M. and A. Zaritsky, Op. cit.
Berrueta, M. y A. Saporiti, Op. cit.
Garza, A. y R. Vallejo, Op. cit.
Parra, D.A., et al, Op. cit.
Slonim A., K. Patel, U. Ruttiman and M. Pollack. 1997. Cardiopulmonary resuscitation in pediatric intensive care units; William & Wilkins. Cap.25 No.12: pp1951-55.
Praveen, K., S. Devait and S. Reeta. 2004. Demographic profile and outcome analysis of a tertiary level pediatric intensive care unit. Indian Journal of Pediatrics. Cap.71No.7: pp587-591.
Thukral, A., R. Lodha, M. Irshad and N.K. Arora. 2006. Performance of pediatric risk of mortality (PRISM) and PIM2 in pediatric intensive care unit in a developing country. Pediatr Crit Care Med. Cap.17 No.4: pp356361.
Slater, A. and F. Shann. 2004. The suitability of the Pediatric Index of Mortality (PIM); PIM2, the pediatric risk of Mortality(PRISM and PRISM III) for monitoring the quality of pediatric intensive care in Australia and New Zealand. Pediatr Crit Care Med. Cap.l5 No.5: pp447-454.
Tan, G.H., T.H. Tan, D.Y.T. Goh and H.K. Yap. 1998. Risk Factors for predicting Mortality in a Pediatric Intensive Care Unit. Ann Acad Med. Singapore. Cap27: pp813-818.
Nawawy, A. 2003. Evaluation of the outcome of patients admitted to the Pediatric Intensive Care Unit in Alexandria usng the Pediatric Risk of Mortality (PRISM) score. Journal of Tropical Pediatrics. Cap.49 No.2: pp109-114.
Murray, P., P. Kantilal and U.E. Ruttimann. 1996. PRISM III: An updated Pediatric Risk of Mortality score Crit Care Med. Cap.24: pp743-752.
Marcin, J.P., A.D. Slonim, M.M. Pollac and U.E. Ruttimann. 2001. Long-stay patients in the pediatric intensive care unit. Crit Care Med. Cap.29 No.3: pp652-657.
Barzilay, Z., E. Somekh, M. Sagy and H. Boichis. 1998. Pediatric cardiopulmonary resuscitation outcome. J Med. Cap.19 No.3-4: pp229-241.
Meaney, P.A., V.M. Nadkarni, E.F. Cook, M. Testa, W. Kaye, G.L. Larkin, R.A. Berg and M. Helfaer. 2006. Higer survival rates among younger patients after pediatrics intensive care unit cardiac arrests. Pediatrics.: Cap.118 No.6: pp2424-33.
Vernon, D.D., J.M. Dean, O.D. Timmons, W. Banner and E.M. Allen-Webb. 1993. Modes of death in the pediatric intensive care unit: withdrawal and limitation of supportive care. Crit Care Med. Cap.21 No.11: pp1798802.
Slonim A., et al, Op. cit.
Praveen, K., et al, Op. cit.
Thukral, A., et al, Op. cit.
Idem.
Slater, A. and F. Shann, Op. cit
De Moss, N., et al, Op. cit.
Slonim A., et al, Op. cit.
Praveen, K., et al, Op. cit.
Thukral, A., et al, Op. cit.
Slater, A. and F. Shann, Op. cit
Tan, G.H., et al, Op. cit.
Nawawy, A., Op. cit.
Murray, P., et al, Op. cit.
Marcin, J.P., et al, Op. cit.
Garza, A. y R. Vallejo, Op. cit.
Nawawy, A., Op. cit.
Barzilay, Z., et al, Op. cit.
Praveen, K., et al, Op. cit.
Meaney, P.A., et al, Op. cit.
De Moss, N., et al, Op. cit.
Praveen, K., et al, Op. cit.
Nawawy, A., Op. cit.
Marcin, J.P., et al, Op. cit.
De Moss, N., et al, Op. cit.
Barzilay, Z., et al, Op. cit.
Slonim A., et al, Op. cit.
Idem.
De Moss, N., et al, Op. cit.
Parra, D.A., et al, Op. cit.
Slonim A., et al, Op. cit.
Vernon, D.D., et al, Op. cit.
Nawawy, A., Op. cit.
Praveen, K., et al, Op. cit.
Thukral, A., et al, Op. cit.
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