Göz Kuruluğu Gelişen Mekanik Ventilatöre Bağlı Pediyatrik Hastaların Klinik Özellikleri: Retrospektif, Tanımlayıcı Bir Çalışma

Öz

Amaç: Bu araştırmanın amacı göz kuruluğu gelişen mekanik ventilatöre bağlı çocuk hastaların klinik özelliklerinin belirlenmesidir. Gereç ve Yöntem: Araştırma retrospektif kohort türündedir. Araştırmanın evrenini İstanbul’da bir üniversite hastanesinin Çocuk Yoğun Bakım Kliniğinde yatan hastalar, örneklemini ise Ağustos 2023- Ağustos 2024 tarihleri arasında yatan, göz kuruluğu gelişmiş mekanik ventilatöre bağlı hastalar oluşturdu. Veriler araştırmacılar tarafından oluşturulan Hasta Bilgi Formu kullanılarak hastane otomasyon sisteminden elde edildi. Verilerin değerlendirmesinde tanımlayıcı istatistiksel yöntemler (ortalama, standart sapma, frekans) Mann-Whitney U testi ve Spearman korelasyon analizi kullanıldı. Bulgular: Belirlenen zaman aralığında tedavi gören 437 hastanın 168’inin entübe olarak takip edildiği ve 35’inde göz kuruluğu geliştiği saptandı. Göz kuruluğu gelişen hastaların yaş ortalaması 4,55 ± 5.19 yıl, mekanik ventilasyon süresi 17,56 ± 11,11 gün, yapay göz damlası başlama zamanı 5,37 ± 3,75’inci gün olarak belirlendi. Hastalarda en sık görülen tanılar %31,4 ile solunum sıkıntısı, %20 ile pnömoni ve %20 ile epilepsi olarak belirlendi. Hastaların %74’ünün midazolam, %65,7’sinin ketamin hidroklorür, %57,1’inin furosemid, %51,4’ünün norepinefrin bitartarat, %48,6’sının fentanil sitrat, %37,1’inin roküronyum bromür infüzyonu aldığı saptandı. Midazolam uygulanan hastalarda göz kuruluğunun daha geç geliştiği, Roküronyum bromür uygulanan hastaların entübasyon süresinin daha uzun olduğu belirlendi (p<0.05). Entübasyon süresi ile göz kuruluğu gelişim hızı arasında pozitif korelasyon saptandı (r=0,725; p=0.001). Sonuç: Bu etkenler göz önünde bulundurulduğunda özellikle mekanik ventilasyon süresi uzayan hastaların göz kuruluğu açısından daha yakından takip edilmesi, koruyucu önlemlerin alınması ve göz bakımının rutin aralıklarla ve bakım paketleri kullanılarak yapılması göz sağlığı için kritik öneme sahiptir.

Anahtar Kelimeler

• çocuk yoğun bakım
• entübasyon
• göz kuruluğu
• mekanik ventilasyon
• retrospektif kohort çalışması

Clinical Characteristics of Mechanically Ventilated Dry Eye Pediatric Patients: A Retrospective Descriptive Study

Abstract

Objective: This study aimed to identify the clinical characteristics of pediatric patients who developed dry eye while receiving mechanical ventilation. Material and Methods: This retrospective cohort study was conducted in the Pediatric Intensive Care Unit (PICU) of a university hospital in Istanbul. The study population included all patients hospitalized in the unit, and the sample consisted of those who were mechanically ventilated and developed dry eye between August 2023 and August 2024. Data were collected from the hospital's electronic medical records using a Patient Information Form developed by the researchers. Descriptive statistics (mean, standard deviation, frequency), the Mann-Whitney U test, and Spearman's correlation analysis were used for data evaluation. Results: Of the 437 patients treated during the study period, 168 were followed while intubated, and 35 of them developed dry eye. The mean age of patients with dry eye was 4.55 ± 5.19 years. The average duration of mechanical ventilation was 17.56 ± 11.11 days, and artificial tear drops were initiated on day 5.37 ± 3.75, on average. The most frequent diagnoses were respiratory distress (31.4%), pneumonia (20%), and epilepsy (20%). Among these patients, 74% received midazolam, 65.7% ketamine hydrochloride, 57.1% furosemide, 51.4% norepinephrine bitartrate, 48.6% fentanyl citrate, and 37.1% rocuronium bromide infusion. It was found that dry eye developed later in patients receiving midazolam, while those administered rocuronium bromide had significantly longer intubation durations (p < 0.05). A positive correlation was found between intubation duration and the rate of dry eye development (r = 0.725; p = 0.001). Conclusion: Considering these factors, it is critically important to monitor patients—especially those with prolonged mechanical ventilation—more closely for dry eye, implement preventive strategies, and perform routine eye care using care bundles to protect ocular health.

Keywords

• dry eye syndromes
• ıntubation
• mechanical ventilation
• pediatric ıntensive care units
• retrospective studies

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