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儿科重症监护病房收治儿童的机械通气相关并发症及合并症:一项横断面回顾性研究。

Mechanical ventilation-associated complications and comorbidities in children admitted at pediatric intensive care unit: A cross-sectional retrospective study.

作者信息

El-Rebigi Amany Mohammed, Fekry Amany Nagah, Elfaramawy Maha A, Zakaria Rasha Mohammed

机构信息

Department of Pediatric and Neonatology, Faculty of Medicine, Benha University, Benha, Egypt.

Department of Anesthesia and Surgical ICU, Faculty of Medicine, Benha University, Benha, Egypt.

出版信息

Turk J Emerg Med. 2025 Jul 1;25(3):230-238. doi: 10.4103/tjem.tjem_251_24. eCollection 2025 Jul-Sep.

Abstract

OBJECTIVES

Mechanical ventilation (MV) is frequently employed in acute care settings for severely ill children, but it may be associated with adverse events (AEs). This study investigated the AEs and comorbidities in children receiving invasive MV (IMV).

METHODS

This retrospective cross-sectional study assessed pediatric patients admitted to the pediatric intensive care unit from January 2021 to December 2023 and received IMV. Demographics, clinical findings, concurrent medical conditions, ventilator settings, complications, and outcomes were collected. The predictors of MV-related AEs were assessed using multivariate logistic regression.

RESULTS

One-quarter (24.1%) of the patients experienced at least one AE. Ventilator-associated pneumonia (VAP) was the most common consequence (13%), followed by postextubation stridor (7.9%) and air-leak syndrome (pneumothorax) (6%). Only 12.4% of cases had comorbidities and the death rate was 9.8%. The factors significantly associated with AEs included nonrespiratory causes for admission, prolonged MV duration, and the presence of comorbidities.

CONCLUSIONS

There is an elevated incidence of AEs, with VAP being the most frequent. Nonrespiratory causes for admission, prolonged MV, and preexisting comorbidities were the main predictors of AEs.

摘要

目的

机械通气(MV)常用于急症护理环境中治疗重症儿童,但它可能与不良事件(AE)相关。本研究调查了接受有创机械通气(IMV)的儿童的不良事件和合并症。

方法

这项回顾性横断面研究评估了2021年1月至2023年12月入住儿科重症监护病房并接受IMV的儿科患者。收集了人口统计学、临床检查结果、并发疾病、呼吸机设置、并发症和结局等信息。使用多因素逻辑回归评估MV相关不良事件的预测因素。

结果

四分之一(24.1%)的患者经历了至少一次不良事件。呼吸机相关性肺炎(VAP)是最常见的后果(13%),其次是拔管后喘鸣(7.9%)和气漏综合征(气胸)(6%)。只有12.4%的病例有合并症,死亡率为9.8%。与不良事件显著相关的因素包括非呼吸原因入院、MV持续时间延长和合并症的存在。

结论

不良事件的发生率较高,其中VAP最为常见。非呼吸原因入院、MV时间延长和既往合并症是不良事件的主要预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/12309813/ab3dc5cce295/TJEM-25-230-g001.jpg

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