title: Risk factors for ventilator-associated pneumonia in infants and children: a cross-sectional cohort study.
abstract: BACKGROUND
  The epidemiology of ventilator-associated pneumonia is well described for adults, but little information is available on risk factors for this disease in children.
  
  
  OBJECTIVE
  To identify predisposing factors for ventilator-associated pneumonia in children.
  
  
  METHODS
  A cross-sectional prospective cohort study of 96 patients in a 9-bed pediatric intensive care unit was performed. Variables examined were demographic characteristics, inpatient care, medications, nutrition, invasive procedures, and characteristics of mechanical ventilation. Data were analyzed by using Pearson χ(2) analysis, Fisher exact and Mann-Whitney tests, odds ratios, and forward stepwise logistic regression.
  
  
  RESULTS
  Occurrence of ventilator-associated pneumonia correlated positively with use of nasoenteral tubes (odds ratio, 5.278; P < .001), intermittent administration of nutritional formula (odds ratio, 6.632; P = .005), emergency reintubation (odds ratio, 2.700; P = .02), use of vasoactive drugs (odds ratio, 5.108; P = .009), duration of mechanical ventilation (P < .001), and length of stay in the pediatric intensive care unit (P < .001) and in the hospital (P = .01).
  
  
  CONCLUSIONS
  Use of vasoactive drugs, presence of a nasoenteral tube, and duration of stay in the pediatric intensive care unit were independent risk factors for ventilator-associated pneumonia.
authors.affiliation: Denise Miyuki Kusahara is a pediatric critical care nurse, Ariane Ferreira Machado Avelar is an adjunct professor, Maria Angélica Sorgini Peterlini and Mavilde da Luz Gonçalves Pedreira are associate professors, Pediatric Nursing Department, and Camila da Cruz Enz is a registered nurse and a former scientific initiation fellow, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil. dkusahara@unifesp.br.
authors.forename: Denise Miyuki
authors.initials: DM
authors.lastname: Kusahara
authors.affiliation: Denise Miyuki Kusahara is a pediatric critical care nurse, Ariane Ferreira Machado Avelar is an adjunct professor, Maria Angélica Sorgini Peterlini and Mavilde da Luz Gonçalves Pedreira are associate professors, Pediatric Nursing Department, and Camila da Cruz Enz is a registered nurse and a former scientific initiation fellow, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Camila da Cruz
authors.initials: Cda C
authors.lastname: Enz
authors.affiliation: Denise Miyuki Kusahara is a pediatric critical care nurse, Ariane Ferreira Machado Avelar is an adjunct professor, Maria Angélica Sorgini Peterlini and Mavilde da Luz Gonçalves Pedreira are associate professors, Pediatric Nursing Department, and Camila da Cruz Enz is a registered nurse and a former scientific initiation fellow, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Ariane Ferreira Machado
authors.initials: AF
authors.lastname: Avelar
authors.affiliation: Denise Miyuki Kusahara is a pediatric critical care nurse, Ariane Ferreira Machado Avelar is an adjunct professor, Maria Angélica Sorgini Peterlini and Mavilde da Luz Gonçalves Pedreira are associate professors, Pediatric Nursing Department, and Camila da Cruz Enz is a registered nurse and a former scientific initiation fellow, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Maria Angélica Sorgini
authors.initials: MA
authors.lastname: Peterlini
authors.affiliation: Denise Miyuki Kusahara is a pediatric critical care nurse, Ariane Ferreira Machado Avelar is an adjunct professor, Maria Angélica Sorgini Peterlini and Mavilde da Luz Gonçalves Pedreira are associate professors, Pediatric Nursing Department, and Camila da Cruz Enz is a registered nurse and a former scientific initiation fellow, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Mavilde da Luz Gonçalves
authors.initials: Mda L
authors.lastname: Pedreira
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016017:Odds Ratio; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors