Background and Aims Ventilator-associated pneumonia (VAP) is a common nosocomial infection in PICU patients, defined as nosocomial pneumonia in patients in mechanical ventilation≥48 hours. We conducted a retrospective study to determine the incidence of VAP and its impact on outcomes in PICU patients.
Methods The medical records of PICU patients admitted to PICU of a tertiary-care hospital from January 2011 to December 2011 were reviewed. Outcomes measures were length of mechanical ventilation and PICU stay, hospital cost and mortality.
Results 127 patients, mean age 4.48±4.25 years, 58.3% boys were enrolled. 27 admissions resulted in development of 31 episodes of VAP, accounting for a VAP rate of 15.33 per 1000 ventilator days. Mean time to diagnosis for the first VAP episode was 14.30±18.58 days from initiation of mechanical ventilation. 4 patients developed 2nd VAP episode at 21.40±17.91 day of mechanical ventilation. Age, sex, presence of comorbidity and PRISM III score at admission did not differ between patients with VAP and those without VAP. Patients with VAP had significantly longer PICU length of stay (46.04±43.68 days vs. 9.10±9.25, P<0,001), greater needs for mechanical ventilation(42.26±43.56 days vs. 6.90±7.75, P<0,001), and higher hospital costs for PICU bed excluding treatment cost (9207.40±8737.80 vs. 1820.00±1850.47, P<0,001), than those without VAP. Patients with VAP presented increased mortality (25.9% vs. 15%), but the difference didn’t reach statistical significance.
Conclusions VAP in critically ill children is associated with prolonged mechanical ventilation, longer PICU stay and increased hospital cost, emerging the need for effective prevention strategies.
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