What is the daily practice of mechanical ventilation in pediatric intensive care units? A multicenter study.
OBJECTIVE
To describe the daily practice of mechanical ventilation (MV), and secondarily, its outcome in pediatric intensive care units (PICUs).


METHODS
Prospective cohort of infants and children who received MV for at least 12 h.


METHODS
Thirty-six medical surgical PICUs.


METHODS
All consecutive patients admitted to the PICUs during 2-month period.


RESULTS
Of the 1893 patients admitted, 659 (35%) received MV for a median time of 4 days (25th percentile, 75%: 2, 6). Median of age was 13 months (25th percentile, 75%: 5, 48). Common indications for MV were acute respiratory failure (ARF) in 72% of the patients, altered mental status in 14% of the patients, and ARF on chronic pulmonary disease in 10% of the patients. Median length of stay in the PICUs was 8 days (25th percentile, 75%: 5, 13). Overall mortality rate in the PICUs was 15% (confidence interval 95%: 13-18) for the entire population, 50% (95% CI: 25-74) in patients who received MV because of acute respiratory distress syndrome, 24% (95% CI: 16-35) in patients who received MV for altered mental status and 16% (95% CI: 9-29) in patients who received MV for ARF on chronic pulmonary disease.


CONCLUSIONS
One in every 3 patients admitted to the PICUs requires ventilatory support. The ARF was the most common reason for MV, and survival of unselected infants and children receiving MV for more than 12 h was 85%.
Farias
J A
JA
Unidad de Cuidados Intensivos Pediátricos, Hospital de Niños R Gutiérrez, B de Irigoyen 49, 1834 Temperley, Buenos Aires, Argentina. jufarias@intramed.net.ar
Frutos
F
F
Esteban
A
A
Flores
J Casado
JC
Retta
A
A
Baltodano
A
A
Alía
I
I
Hatzis
T
T
Olazarri
F
F
Petros
A
A
Johnson
M
M
D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods* / Q000706:statistics & numerical data; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome