Browsing by Autor "Alberto Serra"

Now showing 1 - 2 of 2

P0375 / #530: EPIDEMIOLOGY, PATTERNS OF CARE AND OUTCOMES FOR CHILDREN WITH ACUTE RESPIRATORY FAILURE IN 35 PICUS FROM LATIN AMERICA: INSIGHTS FROM A PROSPECTIVE COLLABORATIVE CLINICAL REGISTRY.
(Lippincott Williams & Wilkins, 2021) Pablo Vásquez‐Hoyos; Franco Díaz; Roberto Jabornisky; Alberto Serra; Regina Grigolli César; Nicolás Monteverde-Fernández; P. Pietroboni; M. Céspedes-Lesczinsky; Adriana Wegner; Pablo del Pino
Aims & Objectives: To describe the epidemiology, therapeutic management and outcomes of children admitted to pediatric ICU (PICU) for acute respiratory failure (ARF) in a contemporary multinational PICU cohort. Methods: Retrospective analysis using prospectively collected clinical data within the LARed Network ARF clinical registry (35 hospitals, 8 Latin-American countries). We analyzed all PICU encounters for ARF that included any respiratory support from May 2017 to October 2019. Demographics, comorbidities, clinical data (including retrieval support and admission severity scores), etiology, PICU respiratory support, adjuvant therapies, and outcomes were described and expressed as median (interquartile percentiles) or relative (percentage) frequencies. Results: Final analysis included 5297 PICU admissions. The main findings are presented in the table. The median age was 5 months (2, 14), 58.1% were males and Bronchiolitis was the most common diagnosis (50.2%) with RSV the most frequent etiology (40.0%). Noninvasive ventilation (NIMV) was the maximal respiratory support in almost 2/3 of encounters from the cohort (61.8%), being high flow nasal cannula (HFNC) and bilevel positive ventilation (BiPAP) the 2 most commonly used techniques. NIMV related complications were low whereas Invasive MV related complications were 21.6%. Although global mortality was low (1.2%), we detected 3.0% of new morbidities at PICU discharge (> 3 change in Functional Status Scale).Conclusions: We present contemporary relevant clinical data regarding ARF epidemiology and patterns of care across Latin-American PICUs. These data provide benchmarks for hospitals to identify current regional practices, assess their performance and guide quality improvement initiatives.
P0380 / #692: PROLONGED MECHANICAL VENTILATION IN CHILDREN ADMITTED WITH ACUTE RESPIRATORY FAILURE TO 33 LATINAMERICAN PEDIATRIC INTENSIVE CARE UNITS: RISK FACTORS AND OUTCOMES.
(Lippincott Williams & Wilkins, 2021) P. Pietroboni; Sebastián González‐Dambrauskas; Franco Díaz; Pablo Vásquez‐Hoyos; Alberto Serra; Nicolás Monteverde-Fernández; M. Céspedes-Lesczinsky; Regina Grigolli César; Roberto Jabornisky
Aims & Objectives: To determine risk factors and outcomes for prolonged invasive mechanical ventilation (pIMV) in infants admitted to pediatric ICU (PICU) due to acute respiratory failure (ARF). Methods: Retrospective analysis using prospectively collected data within LARed Network ARF registry (33 hospitals, 8 countries). All PICU encounters in children younger than 2yo which needed invasive MV (IMV) from May 2017 to October 2019 were included. We defined pIMV as the closest day to the p75 percentile. Demographics, etiology, clinical data and discharge outcomes, late mortality (after 5th day) and PICU acquired morbidity measured with Functional Status Score (FSS). Variables were described and expressed as median (p25, p75) or frequencies (percentage) and adjusted through mixed logistic regression model. Results: Final analysis included 1140 children. Duration of IMV was 111 hours (44, 187). A cut off for pIMV was set at 8 days. Risk factors identified for pIMV were age (OR: 0.96, 0.93-0.99), bronchopulmonary dysplasia (BPD) (OR: 1.96, 1.15-3.35) and home O2 dependency (OR: 2.36, 1.11-5.00). pIMV group had more IMV related complications (OR: 5.13, 3.17-8.30), healthcare-acquired infections (OR: 5.44, 3.11-9.53), and longer PICU length of stay (LOS) (OR: 1.14, 1.11-1.17). Although overall and late mortality were initially not significantly different, when we combine late mortality and new morbidity (change in FSS >3 points), they became significant (OR: 2.55, 1.48-4.37). Conclusions: Age, BPD and O2 dependency are risk factors for pIMV. pIMV was associated with worst patient important outcomes. Reducing IMV time should be a quality improvement metric in our network.