RESUMO
OBJECTIVE: To determine risk factors associated with the presence of complications with mechanical ventilatory support (MVS) in the preterm infants (PI). METHODS: One hundred thirty medical records of PI that had been discharged by amelioration or death were reviewed retrospectively. They were divided in two groups: group A, PI that had presented complications during MVS (cases) and B, PI with MVS, but that had not presented complications due to the procedure (controls). Statistical significance was considered at p < 0.05. RESULTS: The significative risk factors in the multivariate analysis reached significance for the associated of complications: gestational age (32 weeks or less), orotracheal reintubations three o more times, cycles of 60 per minute or more at the third day of being had initiate the MVS, and the symptomatic patent ductus arteriosus (PDA), all with p < 0.05. CONCLUSIONS: It will be necessary to impact more on the cycles level to diminish him below 60 per minute to the third day when it is feasible, to make the smallest reintubations number, to correct quickly the PDA when it is symptomatic, to avoid this way as much as possible, the complications of the MVS.
Assuntos
Doenças do Prematuro/etiologia , Pneumopatias/etiologia , Respiração Artificial/efeitos adversos , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , Doenças do Prematuro/epidemiologia , Pneumopatias/epidemiologia , Masculino , Estudos Retrospectivos , Fatores de RiscoRESUMO
BACKGROUND: Wardrop's formula to estimate available oxygen has been used to assess non-critically ill pre-term newborn infants (PTNIs) of 28-32 weeks gestational age who may need red blood cell transfusion ( RBCT ). The use of this formula has not been analyzed in critically-ill PTNIs. The objective of this study was to compare available oxygen levels before and after RBCTs in critically-ill PTNIs of 28-36 weeks gestational age, and to assess is potential usefulness. MATERIAL AND METHODS: 113 clinical charts of critically-ill PTNIs with at least one RBCT performed between January 1998 and August 2001 were retrospectively reviewed. Hemoglobin concentrations, available oxygen levels and clinical signs of anemia (tachycardia, polypnea, pallor, failure to gain weight) were measured 3 days before, at the moment and 24-72 hours after the RBCT. Descriptive and inferential statistics were used to analyze the results. Statistical significance was considered when p < 0.05. RESULTS: Mean available oxygen levels were 7.99 +/- 1 mL/dL at the moment of the first RBCT (n = 113), 7.91 +/- 0.91 mL/dL at the second (n = 48), and 8.14 +/- 0.83 mL/dL at the third RBCT (n = 22). Available oxygen was significantly higher 24-72 hours after than before all RBCTs (p < 0.01). The mean available oxygen value at the moment of the first, second and third RBCTs was always near 8 mL/dL. CONCLUSIONS: Available oxygen is a good parameter to assess the need for RBCTs in critically-ill PTNIs of 28-36 weeks gestational age. Available oxygen values < 8mL/dL may be another parameter to consider as a criterion for RBCT in these patients.