FAILED EXTUBATION AND PRE- AND POST-EXTUBATION PHYSIOLOGICAL VARIABLES IN CRITICALLY ILL PEDIATRIC PATIENTS

Abstract

Extubation Failed (EF) is the inability to breathe spontaneously within 48 hours after removal of the artificial airway. Objective: To analyze the relationship between failed EF with pre- and post-extubation physiological variables in critically ill pediatric patients Methods: The study was quantitative, observational analytical, case modality (patients with FD) and controls (EE), non-concurrent prospective. The population was made up of 202 admitted to the Pediatric Intensive Care Unit (PICU) of the Instituto Autónomo Hospital Universitario de Los Andes (IAHULA), during 2015-2019. The sample were 150 patients, selected through non-probabilistic sampling, 44 cases and 106 controls. Data was collected through documentary analysis of medical records. Results: 63.5% were male, with a predominance of younger infants (27.3%) and with infections as an admission pathology (p=0.49). 79.5% of cases were administered sedatives and/or neuromuscular relaxants 12 hours prior to extubation. The heart rate, 66.7%, was within the normal range, with tachycardia being the most common in 38.6% of cases. Bradycardia and tachycardia are associated with failed PE, with values of p=0.028 and p=0.037. Blood pressure values were normal in 67.3%, but hypertension was present in 31.8% with FD. The respiratory rate was normal in 61.3%, with tachypnea being present in 45.5% of cases. Tachypnea with a value of p=0.001, and bradypnea with p=0.001, were statistically related to EF. Oxygen saturation was normal in 82.6%, with a low value in 59.1% of cases. On the Glasgow scale, 66.7% presented normal values. Conclusion: Most of the physiological variables presented significant changes, with heart rate and respiratory rate being the ones that presented a statistically significant association with EF.