OBJECTIVE: To assess risk factors and outcomes associated with pediatric ventilator-associated pneumonia. DESIGN: Multicentered prospective observational cohort. SETTING: Children's hospitals in the United States. PATIENTS: Mechanically ventilated patients less than 18 years old. MEASUREMENTS AND MAIN 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.
OBJECTIVE: To assess risk factors and outcomes associated with pediatric ventilator-associated pneumonia. DESIGN: Multicentered prospective observational cohort. SETTING:Children's hospitals in the United States. PATIENTS: Mechanically ventilated patients less than 18 years old. MEASUREMENTS AND MAIN 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: Lori J Bechard; Christopher Duggan; Riva Touger-Decker; J Scott Parrott; Pamela Rothpletz-Puglia; Laura Byham-Gray; Daren Heyland; Nilesh M Mehta Journal: Crit Care Med Date: 2016-08 Impact factor: 7.598
Authors: Mitchell Hamele; Chris Stockmann; Meghan Cirulis; Jay Riva-Cambrin; Ryan Metzger; Tellen D Bennett; Susan L Bratton Journal: J Neurotrauma Date: 2015-10-02 Impact factor: 5.269
Authors: Ben D Albert; David Zurakowski; Lori J Bechard; Gregory P Priebe; Christopher P Duggan; Daren K Heyland; Nilesh M Mehta Journal: Pediatr Crit Care Med Date: 2016-10 Impact factor: 3.624
Authors: Meghan M Cirulis; Mitchell T Hamele; Chris R Stockmann; Tellen D Bennett; Susan L Bratton Journal: Pediatr Crit Care Med Date: 2016-02 Impact factor: 3.624
Authors: Michael Gaies; David K Werho; Wenying Zhang; Janet E Donohue; Sarah Tabbutt; Nancy S Ghanayem; Mark A Scheurer; John M Costello; J William Gaynor; Sara K Pasquali; Justin B Dimick; Mousumi Banerjee; Steven M Schwartz Journal: Ann Thorac Surg Date: 2017-10-05 Impact factor: 4.330