Riffat Farrukh, Amber Naseer, Shaheen Masood, Ibrahim Shakoor, Farhina Nasir, Sarwat Sultana

Mortality Rate and Causing Factors in Ventilator Associated Pneumonia in Children

Riffat Farrukh, Amber Naseer, Shaheen Masood, Ibrahim Shakoor, Farhina Nasir, Sarwat Sultana



1917



ABSTRACT

Aim: To estimate the incidence of ventilator-associated pneumonia (VAP) and to identify causing microbiological organismsand VAP related mortality rate in children admitted to the ICU.

Study design: This was a Cross-sectional and an observational study.

Study place and duration: In the Pediatric department of Abbasi Shaheed Hospital, Karachi, for one-year duration from May 2020 to May 2021.

Methodology: All admitted children to the pediatric ICU (PICU) and ventilated were selected and observed for any features suggestive of VAP. All suspected children have Partial septic signs. A VAP will be categorized ifchild remains on ventilator for more than 48 hours and when a patient had 2 of these signs of nosocomial infection - TLC <4,000 or> 15,000 mm3 , fever> 101 ° F, CRP> 48 mg / L, neutrophils> 85% or a new chest X-rayexhibited pneumonia withradiological sign of progressive, persistent or new infiltrates. The chi-square test was used for comparison of percentages with a value of Less than 0.05 p.

Results: Of all the cases admitted, the average length of ICU stay was 8.65 ± 6.45 per day. Children who needed VAP required 14.2 ±9.5 days of ventilation and 7.5± 5.2 days for children who have not VAP progression. Of 100 cohort of children necessitating ventilation, 22 died and 2 were left without advice or serious illness, with a total mortality of 22%.

Conclusion: The VAP incidence in this study was 22%. Features related with a higher incidence of ventilator-associated pneumonia include age <1-year, continuous intravenous sedation and unplanned intubation in emergency situation. Features suggestive of underlying VAP encompassed, CRP> 48 mg / L, purulent tracheal secretions, positive tracheal culture of aspirate and positive X-ray results.

Key words: Ventilator-associated pneumonia (VAP), Nosocomial infections,PICU and Children



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