Introduction:

Treatment with sedation and neuromuscular blockade is common in pediatric intensive care units, thus increasing the risk of dry eye and corneal ulcer.

Objective:

To determine the incidence of dry eye and corneal ulcer in critically ill children with mechanical ventilation who receive neuromuscular blocker.

Material and methods:

Prospective cohort study. Patients under 18 years of age with mechanical ventilation who received treatment with sedation, analgesia and neuromuscular blocker were included. The evaluation of dry eye was carried out with the Schirmer I test, and by fluorescein staining for corneal ulcer, which was performed at the time of ventilation initiation, and 24, 72 and 120 hours later. All measurements were made by the same Pediatric Ophthalmologist.

Results:

Fifty-six patients were included. At 24 h, 11 patients with dry eye were registered; during this time, no cases with corneal ulcer were documented. At 72 h, two patients developed dry eye and one corneal ulcer. At 120 h, two more patients had dry eye, who developed a corneal ulcer. Thus, in total, the cumulative incidence of dry eye was 26.7% (n = 15) and of corneal ulcer, 5.3% (n = 3).

Conclusion:

In our study, the incidence of dry eye and corneal ulcer were higher than previously reported. Therefore, it is always important that the eyes of patients with mechanical ventilation and neuromuscular blockers have appropriate treatment and evaluation.

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