The Prevalence of Mechanical Issues Andrelated Complications of Intubated Patients Managed by the Pediatric High Dependency Unit at the Georgetown Public Hospital Corporation From January 2021 to December 2021
Introduction
Background / Introduction: Endotracheal intubation involves placement of a tube into the tracheaviathe larynx to maintain a secure and patent airway. There areseveralpotential complications that may occur due to endotrachealintubation. However, the mechanical complications that may occur fromtheprocedure are rarely described. These include accidentalextubation, blocked endotracheal tubes, dislodged tubes, incorrectplacement and airleaks resulting in barotrauma such as pneumothorax.(1)
Objectives
Objective: To evaluate the prevalence of intubation and relatedcomplicationsamong the pediatric patients admitted to PDHU/ICU at GPHCfromJanuary 2021-December 2021.
Method
Methods: Study Design: This is a retrospective observational study. Population Selection: There were a total of 139 admissions to the PHDU with 50intubatedpatients. A total of 34 charts were provided by the recordsdepartment; the remainder were not available.
Results
Results: The prevalence of intubation among the pediatric patients admitted tothePHDU at GPHC from January 2021-December 2021 was 36.6%. The majority of patients (55.9%) spent more than 7 days in the unitwhile44.1% of patients spent less than 7 days. The most commonduration ofintubation was 2-4 days with 35.3% of patients followed by1 day with 29%of patients. At least 73.5% of patients experiencedamechanical/equipment related issue or complication. The majority of patients died (67.6%), while the remaining patientsweredischarged from the unit. Poor outcome had significant positive correlation with blockedtubes, resuscitations and ventilator malfunctions.
Conclusion
Conclusion: The prevalence of mechanical issues and complications at GPHC’sPHDUwas higher than similar studies done globally. Changes need tobeimplemented to decrease the risk of these events occurring. There isstrongcorrelation between mechanical issues and poor outcome.Hence, prevention will likely reduce mortality in the unit.
Recommendations
Recommendations: Adequate monitoring should be done for the patients in the unit. Regularchecks can lead to prophylactic strategies being implemented toreduce theincidence of mechanical issues. Such actions may be regularly changingthe stabilization tape of the ET tube or checking the level of the ET tube toprevent prolonged displacement. Mechanical ventilators are critical to thesurvival of patients in this sample. Emphasis should be placed on regularmaintenance of these machines.