Prevalência e caracterização clínica dos doentes com insuficiência respiratória parcial grave internados numa UCI

 

Alexandra Borba1 ¹

Sofia Lourenço ²

Paulo Marcelino ³

Susan Marum ³

Ana Paula Fernandes ³

 

 

Resumo

Objectivos: A insuficiência respiratória parcial aguda (IRPA) grave é uma situação comum na prática dos cuidados intensivos, mas os estudos existentes são insuficientes. Com este trabalho pretendeu-se estudar a prevalência e caracterizar clinicamente a população de doentes internados numa UCI que apresentam insuficiência respiratória parcial aguda grave.

Material e métodos: Numa unidade de cuidados intensivos médico-cirúrgica avaliaram-se retrospectivamente os doentes internados durante o ano de 2004.

Resultados: 37,6% dos doentes apresentaram IRPA grave. A análise estatística demonstrou que estes doentes diferiam dos doentes sem IRPA nos tempos de internamento e ventilação, índices de gravidade e mortalidade.

Conclusão: A IRPA é uma situação com elevada prevalência e relevância em cuidados intensivos, mas as características destes doentes estão mal definidas, em parte devido à ausência de critérios claros na sua definição. Para melhor compreender este fenómeno são necessários mais estudos, prospectivos e multicêntricos.

Palavras-chave: Insuficiência respiratória parcial, hipoxemia, cuidados intensivos.

 

 

Prevalence and clinical characterisation of patients with severe partial respiratory failure admitted to an intensive care unit

Objective: The authors analysed patients with severe partial respiratory failure (SPRF) admitted to a general Intensive Care Unit (ICU). The prevalence and clinical characteristics of these patients were evaluated.

This work aims to study the rate of and to clinically characterise the patient population admitted to an Intensive Care Unit with acute severe partial respiratory failure.

Material and methods: In 16-bed ICU of a central Hospital in Lisbon, patients admitted in the year 2004 were analysed. Patients with SPRF were recruited form patients with an ICU stay> 24 hours. They were selected according to PaO2 and FiO2 and clinically characterized.

Results: During the study period 472 patients were admitted, and 378 presented an ICU stay> 24 hours and were enrolled. From those, 142 (37.6%) met criteria for SPRF. Of these, 45 (31.7%) a pulmonary aetiology of SPRF was identified. Patients with SRPF were older, had longer ICU stay, and presented higher severity indexes and mortality.

The prevalence of adult respiratory distress syndrome was possible to evaluate in the deceased patients with SPRF (n=52). In these we could find 12 (23%) patients that met criteria for that entity. By multivariate analysis the mortality of patients with SRPF correlated with older age and the presence of circulatory failure (p<0.001).

Conclusions: SPRF is a situation highly prevalent in the ICU studied. To better understand the prevalence of this entity, properly designed studies are needed in order to establish its epidemiology and clinical characteristics.

Key-words: Severe partial respiratory failure, hypoxamia, intensive care unit.

 

 

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1 Interna do Internato Complementar de Pneumologia / Resident, specialising in Pulmonology

2 Interna do Internato Complementar de Medicina Interna / Resident, specialising in Internal Medicine

3 Assistente Hospitalar de Medicina Interna, subespecialista em Medicina Intensiva / Consultant, Internal Medicine, sub-specialist in Intensive Medicine

Hospital de Curry Cabral, Unidade de Cuidados Intensivos (Director, Dr. Luís Mourão)

 

 

Recebido para publicação/received for publication: 07.07.18

Aceite para publicação/accepted for publication: 08.01.07