title: Complications of mechanical ventilation in the pediatric population.
abstract: BACKGROUND
  Mechanical ventilation (MV) strategies are continuously evolving in an effort to minimize adverse events. The objective of this study was to determine the complications associated with MV in children.
  
  
  METHODS
  Prospective observational study. Over a period of 10 consecutive months, 150 patients (median age 0.8 years, IQR 4.4, 59% male) were enrolled in this study.
  
  
  RESULTS
  The median duration of MV was 3.1 days (IQR 3.9). A total of 85 complications were observed in 60 (40%) patients (114 complications per 1,000 ventilation days). 16.7% of patients developed atelectasis, 13.3% post-extubation stridor, 9.3% failed extubation, 2.0% pneumothorax, 3.3% accidental extubation, 2.7% nasal or perioral tissue damage and 1.9% ventilator associated pneumonia. Atelectasis occurred most often in the left lower lobe (36%) or in the right upper lobe (26%). The incidence of atelectasis in children <1 year of age was 12% (31 episodes per 1,000 days of ventilation) compared to 18% (57 episodes per 1,000 days of ventilation) in children ≥ 1 year of age (P < 0.05). Patients that failed extubation were ventilated for a median of 8.5 (IQR 8.8) days compared to 2.9 days (IQR, 3.8) in patients that were successfully extubated (P < 0.01). The absence of an air leak prior to extubation did not correlate with failed extubation. Accidental extubation was limited to orally intubated patients.
  
  
  CONCLUSIONS
  MV complications occurred in 40% of patients and most often consisted of atelectasis and post-extubation stridor. Further studies are needed to examine associated risk factors and strategies to reduce their occurrence.
authors.affiliation: Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada.
authors.forename: Tania
authors.initials: T
authors.lastname: Principi
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Fraser
authors.forename: Gavin C
authors.initials: GC
authors.lastname: Morrison
authors.forename: Sami Al
authors.initials: SA
authors.lastname: Farsi
authors.forename: Jose F
authors.initials: JF
authors.lastname: Carrelas
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Maurice
authors.forename: Alik
authors.initials: A
authors.lastname: Kornecki
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D001261:Pulmonary Atelectasis / Q000209:etiology; D012121:Respiration, Artificial / Q000009:adverse effects*; D012135:Respiratory Sounds / Q000209:etiology; D012307:Risk Factors