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Mechanical ventilation practice in Egyptian pediatric intensive care units

INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanica...

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Autores principales: Meligy, Bassant Salah, Kamal, Sally, El Sherbini, Seham Awad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Electronic physician 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498702/
https://www.ncbi.nlm.nih.gov/pubmed/28713509
http://dx.doi.org/10.19082/4370
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author Meligy, Bassant Salah
Kamal, Sally
El Sherbini, Seham Awad
author_facet Meligy, Bassant Salah
Kamal, Sally
El Sherbini, Seham Awad
author_sort Meligy, Bassant Salah
collection PubMed
description INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital. The study included all children who were intubated and mechanically ventilated for more than 12 hours of admission. Pre-coded data was entered into the SPSS version 21 for data analysis. Comparison between groups was performed using Mann Whitney test for quantitative variables and Chi square with Fisher’s exact test for qualitative ones. Multivariate logistic regression model was conducted to explore the significant predictors for PICU mortality. RESULTS: In total, 893 children were admitted and 293 were mechanically ventilated. The incidence of utilizing MV in children was 32.8%. Neurologic causes were the most common reasons for initiation of MV, with 114 (38.9%) cases. The most commonly preferred mode for initiation of MV is SIMV with PS. Complication occurred in 117 (39.9%) of the cases. The most commonly preferred method of weaning was PS with CPAP in 115/154 (74.7%) cases. Mortality occurred in 134/293 (45.7%) of patients. Duration of mechanical ventilation was significantly longer with neuromuscular diseases, and with the occurrence of complications (p<0.001). There was a significant relationship between mortality and higher PRISM III score, cardiovascular cases, sepsis, multiple organ dysfunction syndrome (MODS), ventilator-associated pneumonia (VAP), and with barotrauma. CONCLUSIONS: In our practice, MV is used oftentimes with almost a third of admissions requiring intubation for different reasons. Most children are ventilated due to neurologic causes. This study paves the way for improving our knowledge of MV with avoiding the fatal complications.
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spelling pubmed-54987022017-07-14 Mechanical ventilation practice in Egyptian pediatric intensive care units Meligy, Bassant Salah Kamal, Sally El Sherbini, Seham Awad Electron Physician Original Article INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital. The study included all children who were intubated and mechanically ventilated for more than 12 hours of admission. Pre-coded data was entered into the SPSS version 21 for data analysis. Comparison between groups was performed using Mann Whitney test for quantitative variables and Chi square with Fisher’s exact test for qualitative ones. Multivariate logistic regression model was conducted to explore the significant predictors for PICU mortality. RESULTS: In total, 893 children were admitted and 293 were mechanically ventilated. The incidence of utilizing MV in children was 32.8%. Neurologic causes were the most common reasons for initiation of MV, with 114 (38.9%) cases. The most commonly preferred mode for initiation of MV is SIMV with PS. Complication occurred in 117 (39.9%) of the cases. The most commonly preferred method of weaning was PS with CPAP in 115/154 (74.7%) cases. Mortality occurred in 134/293 (45.7%) of patients. Duration of mechanical ventilation was significantly longer with neuromuscular diseases, and with the occurrence of complications (p<0.001). There was a significant relationship between mortality and higher PRISM III score, cardiovascular cases, sepsis, multiple organ dysfunction syndrome (MODS), ventilator-associated pneumonia (VAP), and with barotrauma. CONCLUSIONS: In our practice, MV is used oftentimes with almost a third of admissions requiring intubation for different reasons. Most children are ventilated due to neurologic causes. This study paves the way for improving our knowledge of MV with avoiding the fatal complications. Electronic physician 2017-05-25 /pmc/articles/PMC5498702/ /pubmed/28713509 http://dx.doi.org/10.19082/4370 Text en © 2017 The Authors This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/3.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Original Article
Meligy, Bassant Salah
Kamal, Sally
El Sherbini, Seham Awad
Mechanical ventilation practice in Egyptian pediatric intensive care units
title Mechanical ventilation practice in Egyptian pediatric intensive care units
title_full Mechanical ventilation practice in Egyptian pediatric intensive care units
title_fullStr Mechanical ventilation practice in Egyptian pediatric intensive care units
title_full_unstemmed Mechanical ventilation practice in Egyptian pediatric intensive care units
title_short Mechanical ventilation practice in Egyptian pediatric intensive care units
title_sort mechanical ventilation practice in egyptian pediatric intensive care units
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498702/
https://www.ncbi.nlm.nih.gov/pubmed/28713509
http://dx.doi.org/10.19082/4370
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