What is the daily practice of mechanical ventilation in pediatric intensive care units? A multicenter study

Abstract

Objective: To describe the daily practice of mechanical ventilation (MV), and secondarily, its outcome in pédiatrie intensive care units (PICUs). Design: Prospective cohort of infants and children who received MV for at least 12 h. Setting: Thirty-six medical surgical PICUs. Patients: All consecutive patients admitted to the PICUs during 2-month period. Measurements and main results: Of the 1893 patients admitted, 659 (35%) received MV for a median time of 4 days (25th percentile, 75%: 2, 6). Median of age was 13 months (25th percentile, 75%: 5, 48). Common indications for MV were acute respiratory failure (ARF) in 72% of the patients, altered mental status in 14% of the patients, and ARF on chronic pulmonary disease in 10% of the patients. Median length of stay in the PICUs was 8 days (25th percentile, 75%: 5, 13). Overall mortality rate in the PICUs was 15% (confidence interval 95%: 13-18) for the entire population, 50% (95% CI: 25-74) in patients who received MV because of acute respiratory distress syndrome, 24% (95% CI: 16-35) in patients who received MV for altered mental status and 16% (95% CI: 9-29) in patients who received MV for ARF on chronic pulmonary disease. Conclusion: One in every 3 patients admitted to the PICUs requires ventilatory support.. The ARF was the most common reason for MV, and survival of unselected infants and children receiving MV for more than 12 h was 85%.