[Prevalence of mechanical ventilation in pediatric intensive care units in Spain].
OBJECTIVE
To study the prevalence and characteristics of mechanical ventilation in children admitted to Spanish pediatric intensive care units (PICU).


METHODS
A prospective, multicenter, observational study was performed using a written questionnaire sent to the 46 PICUs in Spain. Clinical data and mechanical ventilation settings in patients undergoing mechanical ventilation on 19th February 2002 were collected.


RESULTS
Thirty-three PICUs participated in the study (27 had patients undergoing mechanical ventilation on the study day). The prevalence of mechanical ventilation was 86 patients (45.5 %). The mean age of patients undergoing mechanical ventilation was 36 months and the median was 8 months. Sixty percent of the patients were boys. The main indications for mechanical ventilation were acute respiratory failure (46.5 %), chronic respiratory failure (10.4 %), coma (11.6 %) and postoperative status (10.5 %). Endotracheal tubes were used in 73.2 % and a tracheostomy tube was used in 23.2 %. The most frequent mechanical ventilation modalities used were synchronized intermittent mandatory ventilation (SIMV) in 43 % and control or assisted-control ventilation in 36 %. In 30 % of the patients the duration of mechanical ventilation was longer than 1 month. From the initiation of mechanical ventilation to the study day, pneumothorax developed in 8.1 % of the patients, accidental extubation occurred in 10.5 % and ventilator-associated pneumonia developed in 17.4 %.


CONCLUSIONS
A high percentage of children admitted to the PICU requires mechanical ventilation. The most frequent indication is respiratory failure. The most frequently used modality in children aged less than 1 month is pressure SIMV. In children older than 1 month volume-cycled or pressure-limited ventilation and volume-cycled SMIV are used in similar proportions. The prevalence of prolonged mechanical ventilation and the incidence of ventilator-associated complications are very high.
Balcells Ramírez
J
J
López-Herce Cid
J
J
Modesto Alapont
V
V
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D013030:Spain