Indicadores diagnósticos de desobstrução ineficaz de vias aéreas em crianças com cardiopatia congênita em pós-operatório de cirurgia cardíaca

Abstract

This study aims to analyze the defining characteristics and related factors of the nursing diagnosis of Ineffective Airway Clearance in children and adolescents in the postoperative period of cardiac surgery. The study consists of investigating these indicators in 136 children and adolescents in the postoperative period of surgery for congenital heart disease. This is a cross-sectional, analytical, and quantitative study. The study was conducted from November 2020 to April 2022, in a state public hospital, in an intensive care unit responsible for postoperative care in pediatric cardiac repairs. Data collection involved pulmonary physical examination, interviews with caregivers, and access to medical records. The data were compiled in an Excel® spreadsheet (2022). Statistical analysis was performed using IBM® SPSS® version 25.0 for Windows® and R software version 4.2.0. The results are presented in tables. The research was approved by the Research Ethics Committee, in accordance with the recommendations of Resolution 466/2012, and was approved with opinion number 4.234.559. Most of the children and adolescents participating in the study were male (52.9%). Regarding age, those evaluated ranged from five to 7665 days. The majority underwent corrective surgery (64%), corresponding to the first surgical procedure (69.2%), with a prevalence of cardiopulmonary bypass (66.2%) and postoperative echocardiography (94.9%). Among the most prevalent heart conditions in the sample were: Ventricular Septal Defect (29.4%), Atrial Septal Defect (19.1%), Tetralogy of Fallot and Patent Ductus Arteriosus (16.2%). The diagnosis was present in 44.73% of the children and adolescents. Among the most frequent defining characteristics, the following stand out: absence of cough (94.9%), ineffective cough (51.5%), and altered respiratory rate (30.9%). The most prevalent factors related to ineffective airway clearance were: retained secretions (83.8%) and excessive mucus (27.2%). No influence of causal factors on the occurrence of ineffective airway clearance was found based on the generated logistic regression model. This study contributes to the refinement of clinical reasoning by analyzing indicators of ineffective airway clearance in children in the postoperative period of cardiac surgery.