Epidemiology, risk factors and outcomes of prolonged mechanical ventilation with different cut-points in a PICU

作者：Tatchanapong Chongcharoenyanon, Tatchanapong Chongcharoenyanon, Rujipat Samransamruajkit, Rujipat Samransamruajkit, Jiratchaya Sophonphan · 发表于：Frontiers in Pediatrics · 年份：2023 · DOI：10.3389/fped.2023.1167595 · 被引用次数：8 · 研究领域：Respiratory Support and Mechanisms、Tracheal and airway disorders、Nosocomial Infections in ICU

Background A consensus on the definition of prolonged mechanical ventilation (PMV) for children does not exist. There is still lack of published work presenting the epidemiology, risk factors and outcomes at different cut-points for PMV patients. These are important for planning the goals of treatment and counseling of the prognosis for patient families. We aimed to determine the incidence, baseline characteristics, risk factors and outcomes of PMV in pediatric patients at various cut-points (>14, >21 or >30days). Methods A retrospective cohort study among children <18-years-old who were PMV > 14 days in the PICU of King Chulalongkorn Memorial Hospital was conducted. The primary outcomes were incidence of PMV with various cut-points. We stratified patients into three groups (Group 1; PMV > 14–21, Group 2; >21–30, Group 3; >30 days) for evaluating the baseline characteristics, risk factors, and outcomes of PMV (extubation success, tracheostomy status and death). Factors associated with PMV and deaths were analyzed using univariate and multivariate logistic regression. Results From January 2018 to August 2022, 1,050 patients were screened. Of these, 114 patients were enrolled. The incidence of PMV > 14, >21 and >30 days were 10.9%, 7.3% and 5.0% respectively. Extubation success was significantly lower in Group 3 than in Groups 1 & 2 (15.4% vs. 62.2% & 56.0%, P < 0.001). Consequen...