• Denise Miyuki Kusahara, Camila da Cruz Enz, Ariane Ferreira Machado Avelar, Maria Angélica Sorgini Peterlini, and Mavilde da Luz Gonçalves Pedreira.
• Denise Miyuki Kusahara is a pediatric critical care nurse, Ariane Ferreira Machado Avelar is an adjunct professor, Maria Angélica Sorgini Peterlini and Mavilde da Luz Gonçalves Pedreira are associate professors, Pediatric Nursing Department, and Camila da Cruz Enz is a registered nurse and a former scientific initiation fellow, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil. dkusahara@unifesp.br.
• Am. J. Crit. Care. 2014 Nov 1;23(6):469-76.

BackgroundThe epidemiology of ventilator-associated pneumonia is well described for adults, but little information is available on risk factors for this disease in children.ObjectiveTo identify predisposing factors for ventilator-associated pneumonia in children.MethodsA cross-sectional prospective cohort study of 96 patients in a 9-bed pediatric intensive care unit was performed. Variables examined were demographic characteristics, inpatient care, medications, nutrition, invasive procedures, and characteristics of mechanical ventilation. Data were analyzed by using Pearson χ(2) analysis, Fisher exact and Mann-Whitney tests, odds ratios, and forward stepwise logistic regression.ResultsOccurrence of ventilator-associated pneumonia correlated positively with use of nasoenteral tubes (odds ratio, 5.278; P < .001), intermittent administration of nutritional formula (odds ratio, 6.632; P = .005), emergency reintubation (odds ratio, 2.700; P = .02), use of vasoactive drugs (odds ratio, 5.108; P = .009), duration of mechanical ventilation (P < .001), and length of stay in the pediatric intensive care unit (P < .001) and in the hospital (P = .01).ConclusionUse of vasoactive drugs, presence of a nasoenteral tube, and duration of stay in the pediatric intensive care unit were independent risk factors for ventilator-associated pneumonia.©2014 American Association of Critical-Care Nurses.

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