Abstract P-277: MECHANICAL VENTILATION, PHYSIOLOGICAL STABILITY AND OUTCOME IN MALNOURISHED PATIENTS ADMITTED TO PEDIATRIC INTENSIVE CARE UNIT IN GUATEMALA

Abstract

Aims & Objectives: Determine the quality of care perfomance related in mechanical ventilation and outcome in malnourished pediatrics patients Methods 286 patients Physiological stabillity evaluation based in PRISM socre are performed since admission, 12 hours and 24 hours. Clincal, laboratory and anthropometric consdirations are used to nutritional assesment. Follow up of physiological variables are recorded and compered with the outcome of the patient admitted of PICU in Hospital General San Juan de DIos in GUatemala City. The approach of the chief complait is based to standard approach, guidelines and protocols accepted in the field. 7/ 2015 – 7/2016 Results PRISM socre above 23 pointsis realted with more mortality and the relation of observed and predicted mortality is > 1. Mechanical Ventilation and lack of endorsement of quality standards are related with increase risk in 40 %, realted complications as Ventilator Adquired Pneumonia, Pneumotorax, evidence of higher values of FiO2, higher Tidal Volume, Oxygenation Index, Alveolar-Arterial gradient and lower pH and pO2 since admission and mantain in 72 hours are related with mortality. No difference if related with nutritional status Conclusions The adherence to quality standard in mechanical ventilation, strategies and goals is neceesarry to adjust the mortality realted physiological stability. Nutritional status is no realted with outcome and stabilty approach but for all the performance the evaluation os adherence is strong recommended.