RESUMO
OBJECTIVES: To describe the prevalence and characteristics of delirium during the initial evaluation of critically ill patients aged 5-14â¯years. METHOD/DESIGN: This is a cross-sectional descriptive study in a critical care unit. For six months, all patients were evaluated within the first 24-72â¯hours or when sedation permitted the use of the paediatric confusion assessment method for the intensive care unit (PCAM-ICU) and the Delirium Rating Scale-Revised-98 items #7 and #8 to determine motor type. We report the characteristics of PCAM-ICU delirium (at least three of the required items scored positive) and of subthreshold score cases (two positive items). RESULTS: Of 77 admissions, 15 (19.5%) had delirium, and 11 (14.2%) were subthreshold. A total of 53.3% of delirium and 45.5% of subthreshold cases were hypoactive. The prevalence of delirium and subthreshold PCAM-ICU was 83.3% and 16.7% in mechanically ventilated children. The most frequent combination of PCAM-ICU alterations in subthreshold cases was acute onset-fluctuation with altered alertness. The main nursing diagnoses were related to reduced cellular respiration. CONCLUSIONS: Delirium is common in critically ill children. It is necessary to assess whether certain nursing diagnoses imply an increase in delirium. Longitudinal studies of subthreshold PCAM-ICU cases are needed to understand their importance better.
Assuntos
Delírio/epidemiologia , Prevalência , Adolescente , Criança , Pré-Escolar , Colômbia/epidemiologia , Confusão/classificação , Confusão/epidemiologia , Estudos Transversais , Delírio/diagnóstico , Feminino , Humanos , Unidades de Terapia Intensiva Pediátrica/organização & administração , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Masculino , Psicometria/instrumentação , Psicometria/métodos , Psicometria/estatística & dados numéricosRESUMO
Resumen Objetivo: Describir el comportamiento de los parámetros hemodinámicos en un grupo de individuos sometidos al estudio de monitoreo ambulatorio de la presión arterial. Materiales y métodos: Estudio observacional descriptivo sobre el comportamiento de los parámetros hemodinámicos en el estudio de monitoreo ambulatorio de la presión arterial en un grupo de pacientes atendidos en dos instituciones de Medellín. Resultados: Se analizaron un total de 108 pacientes atendidos en el período comprendido entre septiembre de 2012 y octubre de 2013. Los promedios de la presión arterial sistólica y presión arterial diastólica en 24 horas fueron de 128.34 ± 12.79 mmHg y 75.87 ± 8.74 mm Hg, respectivamente. La media de la presión del pulso fue de 52.47 ± 11.12 mmHg. Las presiones arteriales medias diurna y nocturna fueron de 96,23 ± 9,5 mmHg y 85.19 ± 10,23 mmHg, respectivamente. La frecuencia cardiaca fue de 71.4 ± 10.03 latidos por minuto, para la carga sistólica la media fue de 39,38 ± 27,80% y para la carga diastólica fue de 26,26 ± 24,32%. Conclusiones: El monitoreo ambulatorio de la presión arterial es considerado actualmente como el método más confiable y exacto para el diagnóstico y evaluación de la hipertensión arterial. Permite no solo el diagnóstico y seguimiento del comportamiento de las cifras tensionales en los hipertensos, sino la evaluación de otras variables, como es mostrado en este estudio, con un comportamiento de los resultados muy similar a otros estudios locales.
Abstract Objetive: To describe the behavior of hemodynamic parameters in a group of individuals undergoing ambulatory blood pressure monitoring. Material and methods: Descriptive, observational study on the behavior of hemodynamic parameters in ambulatory blood pressure monitoring of a group of patients assisted in two institutions in Medellín. Results: A total of 108 patients were analysed, assisted between September 2012 and October 2013. Average 24-hour systolic and diastolic blood pressure values were 128.34 ± 12.79 mmHg and 75.87 ± 8,74 mmHg, respectively. Average pulse pressure was 52.47 ± 11.12 mmHg. Day and night blood pressure values were 96.23 ± 9.5 mmHg and 85.19 ± 10.23 mmHg, respectively. Heart rate was 71.4 ± 10.03 beats per minute, it was 39.38 ± 27.80% for the systolic load and 26.26 ± 24.32% for the diastolic load. Conclusions : Ambulatory monitoring of blood pressure is considered nowadays to be the most reliable and exact method for diagnosing and assessing arterial hypertension. Not only does it allow diagnosis and control of the behavior of blood pressure levels in hypertensive patients, but also assesses other variables, like the ones shown in this study, with results being similar to those of other local studies.