Original article
Frequency, risk factors and time to resolution of exposure keratopathy in patients in the Pediatric Intensive Care Unit
Frecuencia, factores de riesgo y tiempo de resolución de la queratopatía por exposición en pacientes de la Unidad de Cuidados Intensivos Pediátrica
Remigio Antonio Pech-Lugoa, Antonio Vázquez-Ceróna, Fany Karina Segura Lópezb, Adriana Dávila-Camargoa,
Corresponding author
a Departamento de Oftalmología, Unidad Médica de Alta Especialidad (UMAE) Hospital de Especialidades No 71, Instituto Mexicano del Seguro Social. Torreón, Coahuila, Mexico
b Departamento de Investigación, Unidad Médica de Alta Especialidad (UMAE) Hospital de Especialidades No 71, Instituto Mexicano del Seguro Social. Torreón, Coahuila, Mexico
Read
Not available
Timeswas read the article
Total PDF
Total HTML
Share statistics
array:23 [ "pii" => "S2173579424001774" "issn" => "21735794" "doi" => "10.1016/j.oftale.2024.10.011" "estado" => "S5" "fechaPublicacion" => "2024-11-01" "aid" => "2295" "copyright" => "Elsevier Ltd. All rights reserved" "copyrightAnyo" => "2024" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S0365669124001904" "issn" => "03656691" "doi" => "10.1016/j.oftal.2024.08.010" "estado" => "S200" "fechaPublicacion" => "2024-09-18" "aid" => "2295" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "Frecuencia, factores de riesgo y tiempo de resolución de la queratopatía por exposición en pacientes de la Unidad de Cuidados Intensivos Pediátrica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Frequency, risk factors and time to resolution of exposure keratopathy in patients in the Pediatric Intensive Care Unit" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R.A. Pech-Lugo, A. Vázquez-Cerón, F.K. Segura López, A. Dávila-Camargo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "R.A." "apellidos" => "Pech-Lugo" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Vázquez-Cerón" ] 2 => array:2 [ "nombre" => "F.K." "apellidos" => "Segura López" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Dávila-Camargo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579424001774" "doi" => "10.1016/j.oftale.2024.10.011" "estado" => "S5" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579424001774?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669124001904?idApp=UINPBA00004N" "url" => "/03656691/unassign/S0365669124001904/v1_202409180432/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2173579424001762" "issn" => "21735794" "doi" => "10.1016/j.oftale.2024.10.010" "estado" => "S5" "fechaPublicacion" => "2024-11-01" "aid" => "2294" "copyright" => "Elsevier Ltd" "documento" => "article" "crossmark" => 0 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Acute macular neuroretinopathy associated with migraine" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neurorretinopatía macular aguda asociada a migraña" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "N Domènech-López, V Llorenç, A Moll-Udina, A Adán" "autores" => array:4 [ 0 => array:2 [ "nombre" => "N" "apellidos" => "Domènech-López" ] 1 => array:2 [ "nombre" => "V" "apellidos" => "Llorenç" ] 2 => array:2 [ "nombre" => "A" "apellidos" => "Moll-Udina" ] 3 => array:2 [ "nombre" => "A" "apellidos" => "Adán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669124001680" "doi" => "10.1016/j.oftal.2024.08.009" "estado" => "S200" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669124001680?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579424001762?idApp=UINPBA00004N" "url" => "/21735794/unassign/S2173579424001762/v1_202411010426/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S217357942030219X" "issn" => "21735794" "doi" => "10.1016/j.oftale.2020.07.009" "estado" => "S200" "fechaPublicacion" => "2020-11-15" "aid" => "1791" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Multimodal imaging in acute idiopathic blind spot enlargement syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Imagen multimodal en el síndrome de aumento idiopático de mancha ciega" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 722 "Ancho" => 1505 "Tamanyo" => 297842 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">At debut, OCT-DE of the first case showed (A) a subfoveal column hyperreflectivity and focal loss of the outer limiting membrane and ellipsoid line at the nasal level (red arrow). The choroidal thinning (white arrow) at nasal level could be physiological and attributable to the patient’s myopia. Subfoveal hyperreflectivity resolved at two weeks (B) leaving a minimal sequel of subfoveal RPE thickening at 1.5 months (C). The outer nasal layers progressively recovered (B and C). In A-OCT 8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>8 <span class="elsevierStyleItalic">en-face,</span> at ellipsoid layer level, hyperreflective points were observed surrounding the papilla (green arrow) at debut (D). After two weeks (E), these peripapillary hyperreflective points decreased but hyporeflective spots were observed (white arrow), which correlate with the disruption of the outer retina in autofluorescence. After 1.5 months (F), hyporeflective spots decreased and white peripapillary spots disappeared. The A-OCT 3<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3 showed at choriocapillary level two apparent hypoperfusion spots in the debut of the disease (G), which correlate with the shadow of the subfoveal column hyperreflectivity.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Moll-Udina, I. Hernanz, M. Dotti, V. Llorenç, A. Adán" "autores" => array:5 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Moll-Udina" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Hernanz" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Dotti" ] 3 => array:2 [ "nombre" => "V." "apellidos" => "Llorenç" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Adán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669120303105" "doi" => "10.1016/j.oftal.2020.07.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669120303105?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357942030219X?idApp=UINPBA00004N" "url" => "/21735794/unassign/S217357942030219X/v1_202011150602/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Frequency, risk factors and time to resolution of exposure keratopathy in patients in the Pediatric Intensive Care Unit" "tieneTextoCompleto" => 0 "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Remigio Antonio Pech-Lugo, Antonio Vázquez-Cerón, Fany Karina Segura López, Adriana Dávila-Camargo" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Remigio Antonio" "apellidos" => "Pech-Lugo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Antonio" "apellidos" => "Vázquez-Cerón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Fany Karina Segura" "apellidos" => "López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:4 [ "nombre" => "Adriana" "apellidos" => "Dávila-Camargo" "email" => array:1 [ 0 => "dra.davila.camargo@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Oftalmología, Unidad Médica de Alta Especialidad (UMAE) Hospital de Especialidades No 71, Instituto Mexicano del Seguro Social. Torreón, Coahuila, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Investigación, Unidad Médica de Alta Especialidad (UMAE) Hospital de Especialidades No 71, Instituto Mexicano del Seguro Social. Torreón, Coahuila, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Frecuencia, factores de riesgo y tiempo de resolución de la queratopatía por exposición en pacientes de la Unidad de Cuidados Intensivos Pediátrica" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2024-03-28" "fechaAceptado" => "2024-08-22" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1903093" "palabras" => array:6 [ 0 => "exposure keratopathy" 1 => "lagophphthalmos" 2 => "sedation" 3 => "PICU" 4 => "mechanical ventilation" 5 => "superficial punctate keratitis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1903092" "palabras" => array:6 [ 0 => "exposure keratopathy" 1 => "lagophftalmos" 2 => "sedation" 3 => "PICU" 4 => "mechanical ventilation" 5 => "superficial punctate keratitis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Exposure keratopathy (EPK) is characterized by punctate erosions of the corneal epithelium, mainly located in the lower third of the cornea. In the Pediatric Intensive Care Unit (PICU), an incidence of 19-25% has been reported. The objective of this study was to describe the frequency, risk factors, and time to resolution of exposure keratitis in PICU patients.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Descriptive, observational, longitudinal, prospective study. The association of keratitis due to exposure to risk factors was evaluated using the Chi square test and determining the OR and 95% confidence interval.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">81 patients admitted to the PICU between March and September 2023 were included, 46 (56.79%) developed PEK, 67.39% (31/46) grade 1 and 26.08% (12/46) grade 3. The median time Resolution was 3 days, interquartile range (2–5). A significant difference was observed between patients with and without PEK in the requirement for mechanical ventilation 86.13% vs., 54.29% p = 0.01, OR = 6.905(2.20-21.64), sedation 100% vs., 85.71%, p = 0.02, in the duration of sedation 5 days vs. 2.5 days (p = 0.024), neuromuscular relaxation 21.74% vs., 0%, p = 0.002, Lagoftalmos 86.94% vs., 31.43% p < 0.00001, OR = 13.33 (4.42-40.17), chemosis 15.21% vs., 0%, p = 0.014 and days of stay in the PICU median 7 (5–11) vs. 3 (2–6), p < 0.00001.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">The frequency of QPE observed was 56.79%, higher than that previously reported in the literature in the pediatric population. Mechanical ventilation, sedation, duration of sedation, Lagoftalmos chemosis and days of stay in the PICU were identified as risk factors.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes y objetivo</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">La queratopatía por exposición (QPE) se caracteriza por erosiones punteadas del epitelio corneal, principalmente localizadas en el tercio inferior de la córnea. En la Unidad de Cuidados Intensivos Pediátrica (UCIP) se ha reportado una incidencia del 19-25%.</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio fue describir la frecuencia, los factores de riesgo y el tiempo de resolución de la queratitis por exposición en pacientes de la UCIP.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y métodos</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo, observacional, longitudinal, prospectivo. Se evaluó la asociación de queratitis por exposición a factores de riesgo mediante la prueba de Chi cuadrado y la determinación de OR e intervalo de confianza al 95%.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 81 pacientes ingresados en la UCIP entre marzo a septiembre 2023, 46 (56.79%) desarrollaron QPE, el 67.39% (31/46) grado 1 y el 26.08% (12/46) grado 3. La mediana del tiempo de resolución fue de 3 días, rango intercuartil (2–5). Se observó diferencia significativa entre pacientes con y sin QPE en el requerimiento de ventilación mecánica 86.13% vs., 54.29% p = 0.01, OR = 6.905(2.20-21.64), sedación 100% vs.,85.71%, p = 0.02, en la duración de la sedación 5 días vs 2.5 días (p = 0.024), relajación neuromuscular 21.74% vs., 0%, p = 0.002, Lagoftalmos 86.94% vs., 31.43% p < 0.00001, OR = 13.33 (4.42-40.17), quemosis 15.21% vs., 0%, p = 0.014 y días de estancia en UCIP mediana 7 (5–11) vs. 3 (2–6), p < 0,00001.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">La frecuencia de QPE observada 56.79%, más alta que la reportada previamente en la literatura en población pediátrica. Se identificaron como factores de riesgo ventilación mecánica, sedación, duración de la sedación, Lagoftalmos quemosis y días de estancia en UCIP.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes y objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/unassign/S2173579424001774/v1_202411010425/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/21735794/unassign/S2173579424001774/v1_202411010425/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579424001774?idApp=UINPBA00004N" ]
