• Pediatr Crit Care Me · Mar 2015

    A Multicentered Prospective Analysis of Diagnosis, Risk Factors, and Outcomes Associated With Pediatric Ventilator-Associated Pneumonia.

    • Sameer Gupta, Brian M Boville, Rachel Blanton, Gloria Lukasiewicz, Jeni Wincek, Chunhong Bai, and Michael L Forbes.
    • 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.
    • Pediatr Crit Care Me. 2015 Mar 1;16(3):e65-73.

    ObjectiveTo assess risk factors and outcomes associated with pediatric ventilator-associated pneumonia.DesignMulticentered prospective observational cohort.SettingChildren's hospitals in the United States.PatientsMechanically ventilated patients less than 18 years old.Measurements And Main ResultsProspective 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.ConclusionsPediatric 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.

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