Author Of 2 Presentations
EXPERIENCE ON POSTOPERATIVE PAEDIATRIC CARDIAC SURGERY IN A PORTUGUESE PAEDIATRIC INTENSIVE CARE UNIT
Abstract
Background
Advances in cardiac surgery over the last few decades, including corrective operations in early life, have dramatically increased the survival of children, particularly those with congenital heart disease.
Objectives
To describe the evolution of patients undergoing cardiac surgery in a Portuguese Paediatric Intensive Care Unit (PICU).
Methods
Retrospective study through databasis of children admitted in PICU in the postoperative period of cardiac surgery, from January 2017 to August 2018.
Results
There were 91 hospitalizations; one of the patients was hospitalized two times in this period. Of 90 patients, 54,4% were male, mean age was 4,27 years [1 month to 18 years]. In this population, 93,3% had congenital heart disease, the most frequent were ventricular and atrial septal defect and Fallot tetralogy; 42,9% had history of another comorbidities and 20,9% have made other cardiac surgeries in the past. Median time of surgery was 287,5 minutes [45-1083min]. In postoperative period, 64,8% were intubated and 27,5% had non-invasive ventilation, with mean duration of mechanical ventilation of 7,8 days. Vasoactive drugs were needed in 48,4% and pacing device in 15,4%; 2 patients needed cardioversion and other 2 patients needed ECMO support. Complications were seen in 50,5%, the most frequent were respiratory and hematologic, and 8,8% of patients required peritoneal dialysis. Deferred closure of the chest was made in 4,4% and 8,8% were reoperated, with one of this patients undergoing heart transplantation. Mortality rate was 2,2% in 20 months of study.
Conclusion
Children undergoing cardiac surgery constitute a high-risk population, justifying a multidisciplinary, differentiated and integrated approach.
WEAPON RELATED TRAUMA IN A PEDIATRIC INTENSIVE CARE UNIT
Abstract
Background
Trauma in Portugal continues to be one of the main causes of death in children and adolescents. Yet, there is a shortage of population-based studies about weapon related trauma in our country.
Objectives
To describe patients hospitalized for weapon related trauma in a Portuguese Pediatric Intensive Care Unit.
Methods
Retrospective study through clinical processes analysis of hospitalized cases for a period of 10 years (January 2006 to December 2017).
Results
Were included 9 cases, 88,9% were male and mean age was 11,3 years. A firearm was used in 66.6% and a white weapon in the remaining cases, 44.4% happened at home, mainly on weekend. Two cases were suicide attempts while in the others the aggressor was either a friend, family or a neighbor. In 5 cases the aggression was intentional, 55,6% the injury was in the head, whereas the rest was in abdomen, back or neck. During hospitalization, all patients were intubated, 5 underwent surgery and 4 required inotropic and transfusional support. Median length of stay was 14,5 days. Overall mortality was 22,2%, corresponding to a 5 and a 14-year-old male, both with severe traumatic brain injury. Of those two patients, Pediatric Risk of Mortality calculated through PRIM III score was 29 and 30 and probability of death was 0.597 and 0.673, respectively. One patient persisted with major sequels and one with minor.
Conclusion
Weapon injuries in children can be associated with severe adverse outcomes including death, which makes this a significant public health problem and a focus to prevention measures in risk groups.