Background: Invasive mechanical ventilation (IMV) is frequently used as a life – supporting device in Pediatric Intensive Care Unit (PICU). To date, there are few studies evaluating the impact of prolonged mechanical ventilation (PMV) in children which is associated with high morbidity and mortality. Our aim was to determine the incidence and factors associated with PMV in PICU at our institution.
Methods: We performed a retrospective review of children aged 1 month – 18 years who were admitted in PICU at Chiang Mai University Hospital between January and December, 2020. PMV was defined if duration of mechanical ventilation (MV) ≥ 96 hours. Baseline characteristics and factors associated with PMV were analysed by descriptive statistics and multivariable regression analysis, respectively. A p-value of <0.05 was considered significant.
Results: Ninety-two episodes of IMV were performed in 90 children. The median (IQR) age of children were 22.8 (7.2-111.6) months (male 64.1%). Forty-six of 92 (50%) children were PMV and32.6% of children with PMV required tracheostomy. The mean (SD) time was 12.4 (± 8.09) days after intubation. Following multivariable analysis, factors associated with PMV were male gender (OR 2.96, 95% CI 1.01 – 8.68, p = 0.048), continuous intravenous sedation (OR 4.34, 95% CI 1.07 – 17.55, p = 0.04) and multiple antibiotics administration during PICU admission (OR 6.62, 95% CI 1.51 – 29.08, p = 0.012), respectively.
Conclusions: Based on our study, the incidence of pediatric PMV was high. Male gender, continuous intravenous sedation and multiple antibiotics administration were associated with pediatric PMV. These findings could help to develop the protocol and therapeutic strategies in PICU to minimize pediatric PMV.
Keywords: prolonged mechanical ventilation; invasive mechanical ventilation; children; pediatric intensive care unit
