Abstract Ref Number = APCP1184
FUNCTIONAL OUTCOME OF INVASIVE MECHANICAL VENTILATION SURVIVAL IN PEDIATRIC INTENSIVE CARE UNIT
Arya Yuniardi Susatya,Sri Fauziyah,Kurniawan Taufiq Kadafi,Saptadi Yuliarto,Ariani Ariani
Pediatric Department Medical Faculty of Brawijaya University Saiful Anwar General Hospital Malang East Java Indonesia Pediatric Department, Medical Faculty of Brawijaya University, Saiful Anwar General Hospital, Malang, East Java, Indonesia Pediatric Emergency and Intensive Care Division Pediatric Department, Medical Faculty of Brawijaya University, Saiful Anwar General Hospital, Malang, East Java, Indonesia Developmental and Behavioural Community Pediatric Division Pediatric Department, Medical Faculty of Brawijaya University, Saiful Anwar General Hospital, Malang, East Java, Indonesia
Background : Although there are more children surviving from critical illness, there is still less data about physical impairment and functional outcome. The functional outcome of patients using mechanical ventilator are still rarely published in Indonesia. The purpose of this study was to assess the functional outcome of patients using invasive mechanical ventilation, considering the central nervous system (CNS) involvement.
Material : This was a prospective study. The inclusion criteria was patient 1 months old - 18 years old age with invasive mechanical ventilator in pediatric care intensive unit (PICU) for at least 48 hours. The study was held in Saiful Anwar Hospital from April to May 2018. The data of pCO2, pO2, duration of ventilation, CNS involvement, and nutritional status were recorded. Functional status scale (FSS) was evaluated 1 and 4 weeks after discharge from PICU. Domain of functional status scale included mental status, sensory functioning, communication, motor functioning, feeding, and respiratory status. Functional status for each domain was categorized into 5 categories from normal to very severe dysfunction. We categorized patient into 2 group, i.e: with CNS involvement and without CNS involvement. Data were descriptively presented.
Results : Seven patients were included. Median of pO2 and pCO2 was 70.3 mmHg (58-80) and 48.7 mmHg (44.5-55.7), respectively. Duration of ventilator and length of stay was 7 days (5-21) and 12 days (8-28). All patients were well-nourished. Four of seven cases had CNS involvement (1 subarachnoid-intraventricular hemorrhage, 1 viral meningoencephalitis, 2 diabetic ketoacidosis). In each group, there was only 1 case of mild dysfunction in 1 week evaluation; whereas all of patients had normal function in 4 weeks evaluation.
Conclusions : Most patients had normal functional outcomes. Patients with mild dysfunction in 1 week after discharge from PICU, had no dysfunction after 4 weeks.
Keywords: Invasive mechanical ventilation pediatric intensive care unit functional scale status central nervous system involvement