Incidence, outcome, and prognostic factors of prolonged mechanical ventilation among children in Chinese mainland: a multi-center survey

作者：Zhengzheng Zhang, Xiaodi Cai, Meixiu Ming, Li Huang, Chengjun Liu, Hong Ren, Dong Qu, Hengmiao Gao, Yibing Cheng, Furong Zhang, Zihao Yang, Wei Xu, Hongjun Miao, Pan Liu, Yuxin Liu, Guoping Lü, Weiming Chen · 发表于：Frontiers in Pediatrics · 年份：2024 · DOI：10.3389/fped.2024.1413094 · 被引用次数：3 · 研究领域：Respiratory Support and Mechanisms、Intensive Care Unit Cognitive Disorders、Cardiac Arrest and Resuscitation

Objective To evaluate the incidence, outcome, and prognostic factors of prolonged mechanical ventilation (PMV) in children in Mainland China. Methods A prospective study was conducted in 11 pediatric intensive care units (PICUs) from May 1, 2021, to April 30, 2022. All pediatric patients on mechanical ventilation meeting the criteria for PMV were included in the study. Results Out of 5,292 patients receiving mechanical ventilation, 278 children met the criteria for PMV (5.3%). After excluding case with incomplete data or lost to follow-up, the study included 250 patients. Among them, 115 were successfully weaned from mechanical ventilation, 90 died, and 45 were still on mechanical ventilation. The 6-month survival rate was 64%. The primary associated conditions of PMV were lower airway diseases (36%), central nervous system diseases (32%), and neuromuscular diseases (14%). The stepwise multiple logistic regression analysis indicated that the utilization of vasoactive agents and an elevated pediatric logistic organ dysfunction-2 (PELOD-2) score on the day of PMV diagnosis were significantly associated with an increased of PMV death. Specifically, the odds ratio (OR) for vasoactive agent use was 2.86; (95% CI: 0.15–0.84; P = 0.018), and for the PELOD-2 score, it was 1.37; 95% CI: 1.17–1.61; P < .001). Conversely, early rehabilitation intervention was negatively associated with the risk of PMV death (OR = 0.45; 95% CI: 0.22–0.93; P = .032). Furthermore, the tracheotomy ti...