Frequency, risk factors and time to resolution of exposure keratopathy in patients in the Pediatric Intensive Care Unit.

Abstract

Background and objective: 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.

Materials and methods: 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.

Results: 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.

Conclusions: 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.