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Respiratory mechanical ventilation
INDICATIONS AND COMPLICATIONS OF MECHANICAL VENTILATION IN PEDIATRIC INTENSIVE CARE UNIT PATIENTS
  1. B Medjo1,
  2. N Vunjak1,
  3. M Atanaskovic-Markovic2,
  4. S Rsovac1,
  5. D Nikolic3,
  6. J Kalanj1,
  7. G Cuturilo2
  1. 1Pediatric Intensive Care Unit, University Children’s Hospital, Belgrade, Serbia
  2. 2Department of Allergology and Pulmonology, University Children’s Hospital, Belgrade, Serbia
  3. 3Department of Neurology, University Children’s Hospital, Belgrade, Serbia

Abstract

Mechanical ventilation is a widely used lifesaving intervention in pediatric intensive care units (PICUs), but as a complex and invasive intervention it is associated with numerous complications.

Objective To assess the indications, complications and outcome of mechanical ventilation in PICU patients.

Methods Medical records of 266 mechanically ventilated patients admitted to a tertiary level PICU from January 2003 to December 2007 were retrospectively reviewed.

Results Out of 1075 patients admitted to the PICU during 5 years, aged from 1 month to 14 years (mean age 3.68 years), 266 (24.7%) patients required mechanical ventilation. The main indications for mechanical ventilation were central nervous system diseases (32.3%), followed by respiratory (29.3%), cardiovascular (27.1%), and neuromuscular (9.4%) diseases, and others (2.6%). The mean duration of mechanical ventilation was 10.8±7.1 days. Complications associated with mechanical ventilation developed in 89 patients (33. 4%), and they included atelectasis (12.8%), ventilator-associated pneumonia (10.5%), pnemothorax (5.3%), laryngeal edema (3.0%) and accidental extubation (1.8%). Patients with respiratory diseases had the highest rate of complications (56.2%), while patients with central nervous system disease had the lowest rate (4.5%). Overall mortality rate of mechanically ventilated patients was 34.5%, and there was no significant difference between ventilated patients with and without complications regarding mortality rate (35.1% vs 33.9%).

Conclusion Central nervous system diseases were the most common indication for mechanical ventilation. Complications associated with mechanical ventilation occurred in 1/3 of ventilated patients, but they did not increase the mortality rate.

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