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Children 2017, 4(7), 56; https://doi.org/10.3390/children4070056

Incidence of Ventilator-Associated Pneumonia in Critically Ill Children Undergoing Mechanical Ventilation in Pediatric Intensive Care Unit

1
Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1551415468, Iran
2
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran 1439955991, Iran
3
Pediatric anesthesiologists and intensivist, Mofid children’s hospital, Shahid Beheshti Medical University, Tehran 1551415468, Iran
4
BS of Nursery, Head Nurse of Pediatric Intensive Care Unit, Mofid children’s hospital, Shahid Beheshti University of Medical Sciences, Tehran 1551415468, Iran
*
Author to whom correspondence should be addressed.
Academic Editor: Sari A. Acra
Received: 27 May 2017 / Revised: 21 June 2017 / Accepted: 27 June 2017 / Published: 3 July 2017
Full-Text   |   PDF [204 KB, uploaded 3 July 2017]

Abstract

Background: Among hospital-acquired infections (HAIs) in children, ventilator-associated pneumonia (VAP) is the most common after blood stream infection (BSI). VAP can prolong length of ventilation and hospitalization, increase mortality rate, and directly change a patient’s outcome in Pediatric Intensive Care Units (PICU). Objectives: The research on VAP in children is limited, especially in Iran; therefore, the identification of VAP incidence and mortality rate will be important for both clinical and epidemiological implications. Materials and Methods: Mechanically ventilated pediatric patients were assessed for development of VAP during hospital course on the basis of clinical, laboratory and imaging criteria. We matched VAP group with control group for assessment of VAP related mortality in the critically ill ventilated children. Results: VAP developed in 22.9% of critically ill children undergoing mechanical ventilation. Early VAP and late VAP were found in 19.3% and 8.4% of VAP cases, respectively. Among the known VAP risk factors that were investigated, immunodeficiency was significantly greater in the VAP group (p = 0.014). No significant differences were found between the two groups regarding use of corticosteroids, antibiotics, PH (potential of hydrogen) modifying agents (such as ranitidine or pantoprazole), presence of nasogastric tube and total or partial parenteral nutrition administration. A substantial number of patients in the VAP group had more than four risk factors for development of VAP, compared to those without VAP (p = 0.087). Mortality rate was not statistically different between the VAP and control groups (p = 0.477). Conclusion: VAP is still one of the major causes of mortality in PICUs. It is found that altered immune status is a significant risk factor for acquiring VAP. Also, occurrence of VAP was high in the first week after admission in PICU. View Full-Text
Keywords: pneumonia; ventilator-associated; incidence; mortality; pediatric intensive care units pneumonia; ventilator-associated; incidence; mortality; pediatric intensive care units
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Amanati, A.; Karimi, A.; Fahimzad, A.; Shamshiri, A.R.; Fallah, F.; Mahdavi, A.; Talebian, M. Incidence of Ventilator-Associated Pneumonia in Critically Ill Children Undergoing Mechanical Ventilation in Pediatric Intensive Care Unit. Children 2017, 4, 56.

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