DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20174737

A study of mechanical ventilation in children

Nilofer S. Bhori, Sunil V. Ghate, Punit S. Chhajed

Abstract


Background: Mechanical ventilation (MV) is one of the most commonly performed procedures in PICU. The indications of MV are multiple. The management strategies also vary depending upon the diseased state, infrastructure and hospital protocols. Although benefits of MV are unquestionable, its use can also cause harm. This study was done to assess the frequency, indications, complications and immediate outcome of mechanically ventilated children, with an aim to improve management protocols and outcome.

Methods: A prospective observational study of children (1 month to 13 years), needing invasive MV in PICU of a medical college. MV was initiated after assessment of indication/s. All patients were ventilated with pressure support modes. Complications and outcome were assessed.

Results: Of 452 patients admitted to PICU, 72 (15.93%) needed MV. Most common indication was respiratory failure (20.83%). Mean duration of MV was 4.2±4.32 days. Mean hospital stay was 11.89±12.8 days. Of 72, 24 (33.33%) developed complication/s, commonest being laryngeal edema (11.11%). Mean duration of ventilation and hospital stay were significantly higher (p <0.01) in those who developed complication/s. The mortality rate of mechanically ventilated children was 38.89%. Initial mode of MV used was significantly associated (p <0.05) with mortality.

Conclusion: Complications prolong the duration of mechanical ventilation and hospital stay. They increase mortality and health care cost in a developing country. Alternatives should be tried before starting invasive MV in children. 


Keywords


Children, Mechanical ventilation, Pediatric intensive care, Respiratory failure

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