title: A multicentered prospective analysis of diagnosis, risk factors, and outcomes associated with pediatric ventilator-associated pneumonia.
abstract: OBJECTIVE
  To assess risk factors and outcomes associated with pediatric ventilator-associated pneumonia.
  
  
  METHODS
  Multicentered prospective observational cohort.
  
  
  METHODS
  Children's hospitals in the United States.
  
  
  METHODS
  Mechanically ventilated patients less than 18 years old.
  
  
  RESULTS
  Prospective evaluation of the prevalence, risk factors, and outcomes of pediatric ventilator-associated pneumonia along with evaluation of diagnostic criterion for pediatric ventilator-associated pneumonia. The prevalence of pediatric ventilator-associated pneumonia was 5.2% (n = 2,082), for a rate of 7.1/1,000 ventilator days. Patients with ventilator-associated pneumonia had a longer unadjusted ICU length of stay (p < 0.0001) and increased length of mechanical ventilation by more than 11 days (p < 0.0001). After adjustment for patient factors, ICU length of stay (p = 0.03) and mechanical ventilation days (p = 0.001) remained significant. Patients with ventilator-associated pneumonia were almost three times more likely to die (p = 0.007). Independent risk factors for ventilator-associated pneumonia were reintubation and part-time ventilation.
  
  
  CONCLUSIONS
  Pediatric ventilator-associated pneumonia is common in mechanically ventilated pediatric patients. These patients have longer length of stay, longer duration of mechanical ventilation, and increased risk for mortality.
authors.affiliation: 1University of Minnesota Masonic Children's Hospital, Minneapolis, MN. 2Helen DeVos Children's Hospital, Grand Rapids, MI. 3Children's Hospital Association, Alexandria, VA. 4Akron Children's Hospital, Akron, OH.
authors.forename: Sameer
authors.initials: S
authors.lastname: Gupta
authors.forename: Brian M
authors.initials: BM
authors.lastname: Boville
authors.forename: Rachel
authors.initials: R
authors.lastname: Blanton
authors.forename: Gloria
authors.initials: G
authors.lastname: Lukasiewicz
authors.forename: Jeni
authors.initials: J
authors.lastname: Wincek
authors.forename: Chunhong
authors.initials: C
authors.lastname: Bai
authors.forename: Michael L
authors.initials: ML
authors.lastname: Forbes
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D015337:Multicenter Studies as Topic; D064887:Observational Studies as Topic; D053717:Pneumonia, Ventilator-Associated / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D015995:Prevalence; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data*; D012307:Risk Factors