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Jornal de Pediatria
Print version ISSN 0021-7557
On-line version ISSN 1678-4782
ALMEIDA-JUNIOR, Armando A. et al. Association between ventilation index and time on mechanical ventilation in infants with acute viral bronchiolitis. J. Pediatr. (Rio J.) [online]. 2005, vol.81, n.6, pp.466-470. ISSN 0021-7557. http://dx.doi.org/10.1590/S0021-75572005000800010.
OBJECTIVE: To evaluate the association between time on mechanical ventilation and anthropometric, clinical and pulmonary function variables, measured early, in infants on invasive mechanical ventilation with acute respiratory failure due to viral bronchiolitis, and the temporal progression of variables with significant correlations. METHODS: Twenty-nine infants admitted to the pediatric intensive care unit of UNICAMP university hospital were studied. Acute viral bronchiolitis was defined according to clinical and radiological criteria. Children with chronic diseases and those that were hemodynamically unstable were excluded. All measurements were taken after 24 to 72 hours' mechanical ventilation, using volumetric capnography and blood gas analysis. Mechanical ventilation time was divided into: < 7 days and > 7 days. Association between time on mechanical ventilation and the variables analyzed was determined by Spearman's Correlation Coefficient (rs). RESULTS: Time on mechanical ventilation showed a significant positive correlation with PaCO2 (rs = 0.45, p = 0.01) and ventilation index (rs = 0.51, p = 0.005), and a negative correlation with pH (rs = -0.40, p = 0.03). Ventilation indices of 37, measured between day one and day five, was associated with a progressively increased risk of more than 7 days on mechanical ventilation (OR = 4.2 on the first day to 15.71 on the fourth day). CONCLUSION: Ventilation index, PaCO2 and pH, measured early, were associated with prolonged mechanical ventilation, reflecting the severity of ventilatory disturbance and the need for support.
Keywords : Pulmonary function; mechanical ventilation; pediatrics; intensive care; acute respiratory failure; dead space.