儿科icu拔管后呼吸模式评估及导管适应症

Alessa Castro Ribeiro, Michele de Morais Rodrigues Sousa
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摘要

目的:应用Downes和Raphaelly提出的Wood-Downes评分和上气道梗阻评分评价患者气管拔管后的呼吸方式及供氧和通气支持装置的适应证。方法:采用横断面、描述性和定量研究。本研究由2018年8月至10月在儿科重症监护病房住院的15名28天至2岁的婴儿组成,符合纳入标准,研究方面遵循伦理。结果:15例患儿中,66.66%为女婴。平均年龄(6.4±6.27)个月。最常见的Wood-Downes评分在基线时为中度,平均为3,4±1,91,第二时刻为轻度,为1,6±0,89。基线时平均上气道阻塞评分为2,9±1,62,第二时刻为1,7±0,79。结论:本研究采用Wood-Downes评分和Downes和Raphaelly提出的上气道阻塞评分来评估呼吸模式,由于中等评分最多,因此在无创通气支持指征方面效果较好。虽然本研究未干预医疗行为,但认为所采用的评分对于婴儿拔管后急性呼吸功能不全的控制和评估是有用的工具。
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Avaliação do padrão respiratório pós extubação e indicação de condutas em UTI pediátrica
OBJECTIVE: To employ the Wood-Downes Score and the upper airway obstruction score proposed by Downes and Raphaelly in the assessment of respiratory patterns and the indication of oxygen and ventilation support devices after orotracheal extubation. METHODS: It is a cross-sectional, descriptive, and quantitative study. The group was composed of 15 infants aged 28 days to 2 years old, hospitalized at the pediatric intensive care unit from august to october 2018, fulfilling the inclusion criteria and following the ethical in research aspects. RESULTS: Out of fifteen infants in the sample, 66,66% were female. The mean age was 6,4 ±6,27 months. The most common Wood-Downes score at baseline was moderate with mean 3,4 ±1,91, going to mild 1,6 ±0,89 at the second moment. The mean upper airway obstruction score at baseline was 2,9 ±1,62 decreasing to 1,7 ±0,79 at the second moment. ONCLUSION: The employment of the Wood-Downes Score and the upper airway obstruction score proposed by Downes and Raphaelly to assess the respiratory patterns in the present study, showed efficacy in the indication of non-invasive ventilatory support because the moderate score was the most present. Although the study did not interfere in the medical conduct, it is believed that the scores employed are useful tools to the control and assessment of the acute respiratory insufficiency after infant extubation.
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