Factors associated with prolonged mechanical ventilation in children with pulmonary failure : Cohort study from the LARed Network registry
Copyright © 2023 Elsevier España, S.L.U. and SEMICYUC. All rights reserved..
OBJECTIVES: To identify factors associated with prolonged mechanical ventilation (pMV) in pediatric patients in pediatric intensive care units (PICUs).
DESIGN: Secondary analysis of a prospective cohort.
SETTING: PICUs in centers that are part of the LARed Network between April 2017 and January 2022.
PARTICIPANTS: Pediatric patients on mechanical ventilation (IMV) due to respiratory causes. We defined IMV time greater than the 75th percentile of the global cohort.
INTERVENTIONS: None.
MAIN VARIABLES OF INTEREST: Demographic data, diagnoses, severity scores, therapies, complications, length of stay, morbidity, and mortality.
RESULTS: 1698 children with MV of 8±7 days were included, and pIMV was defined as 9 days. Factors related to admission were age under 6 months (OR 1.61, 95% CI 1.17-2.22), bronchopulmonary dysplasia (OR 3.71, 95% CI 1.87-7.36), and fungal infections (OR 6.66, 95% CI 1.87-23.74), while patients with asthma had a lower risk of pIMV (OR 0.30, 95% CI 0.12-0.78). Regarding evolution and length of stay in the PICU, it was related to ventilation-associated pneumonia (OR 4.27, 95% CI 1.79-10.20), need for tracheostomy (OR 2.91, 95% CI 1.89-4.48), transfusions (OR 2.94, 95% CI 2.18-3.96), neuromuscular blockade (OR 2.08, 95% CI 1.48-2.93), high-frequency ventilation (OR 2.91, 95% CI 1.89-4.48), and longer PICU stay (OR 1.13, 95% CI 1.10-1.16). In addition, mean airway pressure greater than 13cmH2O was associated with pIMV (OR 1.57, 95% CI 1.12-2.21).
CONCLUSIONS: Factors related to IMV duration greater than 9 days in pediatric patients in PICUs were identified in terms of admission, evolution, and length of stay.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Medicina intensiva - 48(2024), 1 vom: 21. Jan., Seite 23-36 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Barajas-Romero, Juan Sebastián [VerfasserIn] |
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| Links: |
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| Themen: |
Insuficiencia respiratoria |
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| Anmerkungen: |
Date Completed 05.01.2024 Date Revised 10.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.medine.2023.07.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359817084 |
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| 245 | 1 | 0 | |a Factors associated with prolonged mechanical ventilation in children with pulmonary failure |b Cohort study from the LARed Network registry |
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| 500 | |a Date Revised 10.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier España, S.L.U. and SEMICYUC. All rights reserved. | ||
| 520 | |a OBJECTIVES: To identify factors associated with prolonged mechanical ventilation (pMV) in pediatric patients in pediatric intensive care units (PICUs) | ||
| 520 | |a DESIGN: Secondary analysis of a prospective cohort | ||
| 520 | |a SETTING: PICUs in centers that are part of the LARed Network between April 2017 and January 2022 | ||
| 520 | |a PARTICIPANTS: Pediatric patients on mechanical ventilation (IMV) due to respiratory causes. We defined IMV time greater than the 75th percentile of the global cohort | ||
| 520 | |a INTERVENTIONS: None | ||
| 520 | |a MAIN VARIABLES OF INTEREST: Demographic data, diagnoses, severity scores, therapies, complications, length of stay, morbidity, and mortality | ||
| 520 | |a RESULTS: 1698 children with MV of 8±7 days were included, and pIMV was defined as 9 days. Factors related to admission were age under 6 months (OR 1.61, 95% CI 1.17-2.22), bronchopulmonary dysplasia (OR 3.71, 95% CI 1.87-7.36), and fungal infections (OR 6.66, 95% CI 1.87-23.74), while patients with asthma had a lower risk of pIMV (OR 0.30, 95% CI 0.12-0.78). Regarding evolution and length of stay in the PICU, it was related to ventilation-associated pneumonia (OR 4.27, 95% CI 1.79-10.20), need for tracheostomy (OR 2.91, 95% CI 1.89-4.48), transfusions (OR 2.94, 95% CI 2.18-3.96), neuromuscular blockade (OR 2.08, 95% CI 1.48-2.93), high-frequency ventilation (OR 2.91, 95% CI 1.89-4.48), and longer PICU stay (OR 1.13, 95% CI 1.10-1.16). In addition, mean airway pressure greater than 13cmH2O was associated with pIMV (OR 1.57, 95% CI 1.12-2.21) | ||
| 520 | |a CONCLUSIONS: Factors related to IMV duration greater than 9 days in pediatric patients in PICUs were identified in terms of admission, evolution, and length of stay | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Intensive Care Units Pediatric | |
| 650 | 4 | |a Respiración artificial | |
| 650 | 4 | |a Respiration artificial | |
| 650 | 4 | |a Respiratory insufficiency | |
| 650 | 4 | |a Unidades de Cuidado Intensivo Pediátrico | |
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| 700 | 1 | |a Grigolli, Regina |e verfasserin |4 aut | |
| 700 | 1 | |a Monteverde-Fernández, Nicolas |e verfasserin |4 aut | |
| 700 | 1 | |a Gonzalez-Dambrauskas, Sebastián |e verfasserin |4 aut | |
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