Invasive medical devices and icu mortality: a comparative study of patients with and without covid-19
DOI:
https://doi.org/10.5433/anh.2025v7.id51525Keywords:
Intensive Care Units, Equipment and Supplies, COVID-19, Critical Care, MortalityAbstract
Objective: o evaluate the length of stay and the risk of death among COVID-19 patients using invasive medical devices while admitted to intensive care units. Method: This was a quantitative, longitudinal study with a retrospective cohort design, based on data from 257 medical records of adult patients admitted to intensive care between 2020 and 2021 at a university hospital. Data collection was carried out in 2022 over a period of eight months using a structured collection instrument. The results were tabulated in Excel 2010. and statistical analyses were performed using the Statistical Package for the Social Sciences, version 20.0. Survival analysis was conducted, including calculation of the Hazard Ratio. Results: Prolonged use of invasive medical devices was observed in COVID-19 patients during their stay in the intensive care unit, with a particular prevalence of central venous catheters and nasoenteric tubes. This group also experienced longer use of orotracheal tubes. The use of invasive medical devices on the seventh day of hospitalization increased and was strongly associated with a higher risk of death among COVID-19 patients. Conclusion: COVID-19 patients used more hospital medical devices, with orotracheal tubes, central venous catheters, indwelling urinary catheters, and nasoenteric tubes being the most common. These devices were associated with longer durations of use and a higher risk of death compared to patients without a COVID-19 diagnosis. Rates of mechanical ventilation and oxygen therapy were also higher in the COVID-19 grou.
Downloads
References
1.Agência Nacional de Vigilância Sanitária. (BR). RDC nº 7 de 24 de fevereiro de 2010. Dispõe sobre os
requisitos mínimos para funcionamento de Unidades de Terapia Intensiva e dá outras providências. Diário Oficial República Federativa do Brasil, Poder Executivo, Brasília (DF): ANVISA, 2010. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2010/res000724022010.html.
2.Mendonça JG, Guimarães MJB, Mendonça UG, Portugal JL, Mendonça CG. Profile of hospitalizations in Pediatric Intensive Care Units of the Brazilian Unified Health System in the state of Pernambuco, Brazil. Cien Saude Colet. 2019. 24:907-16. doi: 10.1590/1413-81232018243.02152017.
3.De Souza DC, Machado FR. Epidemiology of pediatric septic shock. J. Pediatr. Intensive Care. 2019. 8(1):3-10.doi: 10.1590/1413-81232018243.02152017. DOI: https://doi.org/10.1590/1413-81232018243.02152017
4.Carlton EF, Perry-Eaddy MA, Prescott HC. Context and Implications of the New Pediatric Sepsis Criteria. JAMA. 2024. 21:E1-E4. doi: 10.1001/jama.2023.27979. DOI: https://doi.org/10.1001/jama.2023.27979
5.Schlapbach LJ et al. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024. 21:E2-E10. doi: 10.1001/jama.2024.0179. DOI: https://doi.org/10.1001/jama.2024.0179
6.Weiss SL, Peters MJ, Alhazzani W, Agus MSD, Flori HR, Inwald DP, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Med. 2020. 46(1):10-67. doi: 10.1007/s00134-019-05878-6. DOI: https://doi.org/10.1007/s00134-019-05878-6
7.Pérez DV, Jordan L, Esteban E, Gárcia-joler P, Murga V, Bonil V, et al. Prognostic factors in pediatric sepsis study, from the Spanish Society of Pediatric Intensive Care. J Pediatr Infect Dis. 2014. 33(2):152-7. doi:10.1097/01.inf.0000435502.36996.72. DOI: https://doi.org/10.1097/01.inf.0000435502.36996.72
8.Wolfler A, Silvan P, Musicco M, Antonelli M, Salvo I. Incidence of and mortality due to sepsis, severe sepsis and septic shock in Italian Pediatric Intensive Care Units: a prospective national survey. Intensive Care Med. 2008. 34(9):1690-7. doi: 10.1007/s00134-008-1148-y. DOI: https://doi.org/10.1007/s00134-008-1148-y
9.Xiao C, Wang S, Fang F, Xu F, Xiao S, Li B, et al. Epidemiology of pediatric severe sepsis in main PICU centers in Southwest China. Pediatr Crit Care Med. 2019. 20(12):1118-25. doi:10.1097/PCC.0000000000002079. DOI: https://doi.org/10.1097/PCC.0000000000002079
10. Souza DC, Oliveira CF, Lanziotti ZF. Pediatric sepsis research in low- and middle-income
countries: overcoming challenges. Rev Bras Ter Intensiva. 2021, 33(3):341-345. doi: 10.5935/0103-507X.20210062. DOI: https://doi.org/10.5935/0103-507X.20210062
11. Boeddha NP, Schapbach LJ, Driessen GJ, Herberg JA, Rivero- calle I, Cabey-lopéz M, et al. Mortality and morbidity in community-acquired sepsis in European pediatric intensive care units: a prospective cohort study from the European Childhood Life-threatening Infectious Disease Study (EUCLIDS). Crit Care Med. 2018,22(1):1-13. doi: 10.1186/s13054-018-2052-7. DOI: https://doi.org/10.1186/s13054-018-2052-7
12. Kamath S, Altaq HH, Abdo T. Management of Sepsis and Septic Shock: What Have We Learned in the Last Two Decades? Microorganisms. 2023, 11(2231):1-28. doi: 10.3390/microorganisms11092231. DOI: https://doi.org/10.3390/microorganisms11092231
13. Tan B, Wong JJM, Sultana R, Koh JCJW, Jit M, Mok YH, et al. Global case-fatality rates in pediatric severe sepsis and septic shock: a systematic review and meta-analysis. JAMA Pediatr. 2019, 173(4):352-62. doi: 10.1001/jamapediatrics.2018.4839. DOI: https://doi.org/10.1001/jamapediatrics.2018.4839
14. Razzaque J, Muhammad N, Hamid, MH. Frequency of need for Mechanical Ventilation and Dialysis in Children with Septic Shock. JPMA. J Pak Med Assoc. 2020, 70(11):2057-60. doi: 10.5455/JPMA.36238 DOI: https://doi.org/10.5455/JPMA.36238
15. Cruz AT, Lane RD, Balamith F, Aronson PL, Ashby DW, Neuman MF, et al. Updates on pediatric sepsis. J Am Coll Emerg Physicians Open. 2020, 1(5):981-93. doi: 10.1002/emp2.12173. DOI: https://doi.org/10.1002/emp2.12173
16. Garcia PCR, Tonial CT, Piva JP. Septic shock in pediatrics: the state-of-the-art. J Pediatr (Rio J). 2020, 96:87-98. doi: https://doi.org/10.1016/j.jped.2019.10.007. DOI: https://doi.org/10.1016/j.jped.2019.10.007
17. Stenson EK, Banks RK, Reeder RW, Maddux AB, Zimmerman J, Meert KL, Mourani PM. Fluid balance and its association with mortality and health-related quality of life: a nonprespecified secondary analysis of the life after pediatric sepsis evaluation. Pediatr Crit Care Med. 2023, 24(10):829-839. doi: 10.1097/PCC.0000000000003294. DOI: https://doi.org/10.1097/PCC.0000000000003294
18. Silva YF, Tacla MTGM, Costa DCZ, Kerbauy G, Mendes PBS. Infection related to health care and sepsis in hospitalization in pediatrics. Ciênc Cuid Saúde. 2021, 20:e55782. doi: 10.4025/ciencuidsaude.v20i0.55782. DOI: https://doi.org/10.4025/ciencuidsaude.v20i0.55782
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ana Paula da Silva, Fabiana Fernandes Gamba, Renata Perfeito Ribeiro, Jhennifer Camila Peixoto, Helenize Ferreira Lima Leachi, Francieli Faustino, Luana Graziely Parra da Silva, Aline Franco da Rocha (Autor)
This work is licensed under a Creative Commons Attribution 4.0 International License.
All or the content of the newspaper is licensed under a Creative Commons Attribution License, of the CC-BY attribution type.
Authors retain the copyright, and authors are asked to indicate first publication in this journal in the event of republication. Articles published in Advances in Nursing and Health are licensed under the Creative Commons Attribution 4.0 International License, which ensures Open Access. This license allows any user to read, download, copy, and share the content, as long as it is properly cited. It also permits the reuse of the material, including its distribution, adaptation, and creation of derivative works in any format or medium, provided appropriate credit is given, a link to the license is provided, and any changes made are indicated. In addition, the license allows commercial use of the content.
