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Archivos argentinos de pediatría

versión impresa ISSN 0325-0075versión On-line ISSN 1668-3501

Resumen

MORENO, Rodolfo P. et al. Intubación endotraqueal: complicaciones inmediatas en dos unidades de cuidados intensivos pediátricos. Arch. argent. pediatr. [online]. 2006, vol.104, n.1, pp.15-22. ISSN 0325-0075.

Introduction. Endotracheal intubation is one of the most frequent procedures performed in pediatric intensive care units. There is limited literature about the complications caused by it and most of it concerns adult patients. Objectives. To identify the complications related to endotracheal intubation in two pediatric intensive care units. To describe the way in which this procedure is being carried out in these two units. To determine the most frequently used drugs in endotracheal intubation. Population, material and methods. Inclusion criteria: all patients admitted between 01/01/2001-31/12/2001 who required endotracheal intubation. Design: A descriptive and prospective study. Results. A total of 116 procedures were evaluated. Mean age was 24.3 months; 53% were below 6 months. The leading cause of endotracheal intubation was respiratory illness: 83 patients (71.6%). Endotracheal intubation was orotracheal in 100% of patients. The size of the endotracheal tube was adequate in 81% of cases and more than one attempt was necessary in 22% of them. A total of 54 complications were recorded (46.5%), 42 mild and 12 severe. The most frequent complication was the displacement of the endotracheal tube which was clinically detected, followed in decreasing frequency by: bradicardia, displacement of the endotracheal tube detected by chest X-ray, right main bronchus intubation and right upper lobe atelectasis there were 65 (56%) not programmed intubations and 51 (43.9%) were programmed. The incidence of complications was higher in the not programmed intubations than in the programmed ones (61.5 vs. 27.4% respectively). These differences were statically significant (RR 2.24, CI 95 1.38-3.64). The most utilized drugs were midazolam (81%), fentanyle (50.8%), ketamine (44.8%) and pancuronium (34.4%). Conclusions. There were a high incidence of complications most were mild, 22% were serious and none fatal. Endotracheal intubation was always performed by orotracheal route with adequate preoxygenation. All patients were monitored throughout the procedure. Midazolam, fentanyle and ketamine were the most prescribed drugs.

Palabras clave : Endotracheal intubation; Complications; Adverse events; Pediatric intensive care unit.

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