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Pediatr Crit Care Med. 2015 Mar;16(3):e65-73. doi: 10.1097/PCC.0000000000000338.

A multicentered prospective analysis of diagnosis, risk factors, and outcomes associated with pediatric ventilator-associated pneumonia.

Author information

1
1University of Minnesota Masonic Children's Hospital, Minneapolis, MN. 2Helen DeVos Children's Hospital, Grand Rapids, MI. 3Children's Hospital Association, Alexandria, VA. 4Akron Children's Hospital, Akron, OH.

Abstract

OBJECTIVE:

To assess risk factors and outcomes associated with pediatric ventilator-associated pneumonia.

DESIGN:

Multicentered prospective observational cohort.

SETTING:

Children's hospitals in the United States.

PATIENTS:

Mechanically ventilated patients less than 18 years old.

MEASUREMENTS AND MAIN RESULTS:

Prospective evaluation of the prevalence, risk factors, and outcomes of pediatric ventilator-associated pneumonia along with evaluation of diagnostic criterion for pediatric ventilator-associated pneumonia. The prevalence of pediatric ventilator-associated pneumonia was 5.2% (n = 2,082), for a rate of 7.1/1,000 ventilator days. Patients with ventilator-associated pneumonia had a longer unadjusted ICU length of stay (p < 0.0001) and increased length of mechanical ventilation by more than 11 days (p < 0.0001). After adjustment for patient factors, ICU length of stay (p = 0.03) and mechanical ventilation days (p = 0.001) remained significant. Patients with ventilator-associated pneumonia were almost three times more likely to die (p = 0.007). Independent risk factors for ventilator-associated pneumonia were reintubation and part-time ventilation.

CONCLUSIONS:

Pediatric ventilator-associated pneumonia is common in mechanically ventilated pediatric patients. These patients have longer length of stay, longer duration of mechanical ventilation, and increased risk for mortality.

PMID:
25607739
DOI:
10.1097/PCC.0000000000000338
[Indexed for MEDLINE]

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