Artículos de revistas
Risk Factors Of Death In Children With Diarrhea And Shock Admitted To The Intensive Care Unit [o óbito Em Crianças Com Diarréia Aguda E Choque Em Uti]
Registro en:
Revista Da Associacao Medica Brasileira. , v. 51, n. 4, p. 237 - 240, 2005.
1044230
10.1590/S0104-42302005000400022
2-s2.0-33645744476
Autor
Brandao M.B.
Lopes C.E.
Morcillo A.M.
Baracat E.C.E.
Institución
Resumen
BACKGROUND. Describe clinical and epidemiological characteristics of pediatric patients diagnosed with acute diarrhea and shock, admitted to the pediatric intensive care unit, in order to compare the evolution of clinical data between the survival and non-survival groups, thereby identifying the risk factors of death. METHODS. In the Pediatric Intensive Care Unit of the Clinical Hospital at the State University of Campinas (UNICAMP), a non-controlled, descriptive and retrospective study was carried out from February 1994 to January 1998 The epidemiological and clinical/evolution data were analyzed and the groups of those who survived (56) and did not survive (15) were compared. For continuous variables, the Chi-Square test was used and for categorical variables, the Fisher's Exact test, for values lower than five. RESULTS. Seventy one children aged from 0.4 to 13.9 months were admitted, 15 of them died (21.2%). Low birth weight was found in 18.1% and the mean breast-feeding time was 1.1 months. The average length of stay was 5.6 days. 52/71 children needed mechanical ventilation, use of vasoactive drugs and sodium bicarbonate was necessary in 23/71 and 15/71, respectively. 93% of children were given antibiotics. The use of sodium bicarbonate, vasoactive drugs and mechanical ventilation showed an association with risk of death, but only vasoactive drugs (OR=18.56) and an age less than 3 months (OR=0.10) showed a statistically significant difference in multivariate analysis. Artigo recebido: 06/05/04 CONCLUSIONS. Acute diarrhea and shock occurred mainly in children under 3 months of age with a severe clinical/laboratorial condition. During clinical evolution, the high risk of death was related to the use of vasoactive drugs, a support therapy used in critical patients. 51 4 237 240 Claeson, M., Merson, M.H., Global progress in the control of diarrheal diseases (1990) Pediatr Infect Dis J, 9, pp. 345-355 Berns, C., Martines, J., De Zoysa, I., Glass, R.I., The magnitude of the global problem of diarrhoeal disease: A ten-year update (1992) Bull World Health Org, 70, pp. 705-714 Montarjemi, Y., Käferstein, F., Moy, G., Quevedo, F., Contamineted weaning food: A major risk factor for diarrhoea and associated malnutrition (1993) Bull World Health Org, 71, pp. 79-92 Morais, T.B., Morais, M.B., Sigulem, D.M., Bacterial contamination of the lacteal contents of feeding bottles in metropolitan São Paulo, Brazil (1998) Bull World Health Org, 76 (2), pp. 173-181 Bone, R.C., Balk, R.A., Cerra, F.B., Dellinger, R.P., Fein, A.M., Knaus, W.A., Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis (1992) Chest, 101, pp. 1644-1655 Tobin, J.R., Wetzel, R.C., Shock and multi-organ system dysfunction (1996) Textbook of Pediatric Intensive Care. 3rd Ed., pp. 555-606. , Rogers MC. Baltimore: Williams & Wilkins Mitra, A.K., Khan, M.R., Alam, A.N., Complications and outcome of disease in patients admitted to the intensive care unit of a diarrhoeal diseases hospital in Bangladesh (1991) Trans R Soc Trop Med Hyg, 85, pp. 685-687 Andrade, J.A., Oliveira, J.O., Fagundes Neto, U., Lethality in hospitalized infants with acute diarrhea: Risk factors associated with death (1999) Rev Assoc Med Bras, 45, pp. 121-127 Teka, T., Faruque, A.S.G., Fuchs, G.J., Risk factors for deaths in under-age-five children attending a diarrhoea treatment centre (1996) Acta Paediatr, 85, pp. 1070-1075 Griffin, P.M., Ryan, C.A., Nyaphisi, M., Hargrett-Bean, N., Waldman, R.J., Risk factors for fatal diarrhea: A case-control study of African children (1988) Am J Epidemiol, 128 (6), pp. 1322-1329 Kilgore, P.E., Holman, R.C., Clarke, M.J., Glass, R.I., Trends do diarrheal disease-associated mortality in US children, 1968 through 1991 (1995) JAMA, 274, pp. 1143-1148 Shukry, S., Zaki, A.M., Dupont, H.L., Shoukry, I., Tagi, M.E., Hamed, Z., Detection of enteropathogens in fatal and potentially fatal diarrhea in Cairo, Egypt (1986) J Clin Microbiol, 24, pp. 959-962 Sweet, A.Y., Classificação do neonato de baixo peso (1990) Alto Risco Em Neonatologia, pp. 62-86. , Klauss MH, Fanaroff AA. Rio de Janeiro: Guanabara Koogan Victora, C.G., Barros, F.C., Vaughan, J.P., Teixeira, A.M.B., Birthweight and infant mortality: A longitudinal study of 5914 Brazilian children (1987) Int J Epidemiol, 16, pp. 239-245 Victora, C.G., Smith, P.G., Vaughan, J.P., Nobre, L.C., Lombardi, C., Teixeira, A.M.B., Influence of birth weight on mortality from infectious diseases: A case-control study (1988) Pediatrics, 81, pp. 807-811 Post, C.L.A., Victora, C.G., Valente, J.G., Leal, M.C., Niobey, F.M.L., Sabroza, P.C., Fatores prognósticos de letalidade hospitalar por diarréia ou pneumonia em menores de um ano de idade. Estudo de caso e controle (1992) Rev Saúde Publica, 26, pp. 369-378 Huttly, S.R.A., Morris, S.S., Pisani, V., Prevention of diarrhoea in young children in developing countries (1997) Bull World Health Org, 75, pp. 163-174