TY - JOUR
T1 - Factors associated with prolonged mechanical ventilation in children with pulmonary failure
T2 - Cohort study from the LARed Network registry
AU - en representación de LARed Network
AU - Barajas-Romero, Juan Sebastian
AU - Vásquez-Hoyos, Pablo
AU - Pardo, Rosalba
AU - Jaramillo-Bustamante, Juan Camilo
AU - Grigolli, Regina
AU - Monteverde-Fernández, Nicolas
AU - Gonzalez-Dambrauskas, Sebastian
AU - Jabornisky, Roberto
AU - Cruces, Pablo
AU - Wegner, Adriana
AU - Díaz, Franco
AU - Pietroboni, Pietro
N1 - Publisher Copyright:
© 2023 Elsevier España, S.L.U. y SEMICYUC
PY - 2024/1
Y1 - 2024/1
N2 - 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: One thousand 6 hundred and ninety 8 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 13 cmH2O 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.
AB - 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: One thousand 6 hundred and ninety 8 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 13 cmH2O 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.
KW - Intensive Care Units Pediatric
KW - Respiration artificial
KW - Respiratory insufficiency
UR - http://www.scopus.com/inward/record.url?scp=85166301280&partnerID=8YFLogxK
U2 - 10.1016/j.medin.2023.06.005
DO - 10.1016/j.medin.2023.06.005
M3 - Article
AN - SCOPUS:85166301280
SN - 0210-5691
VL - 48
SP - 23
EP - 36
JO - Medicina Intensiva
JF - Medicina Intensiva
IS - 1
ER -