New morbidity following critical illness in Latin American children under 18 years old with lower respiratory tract infection

Abstract

The acquisition of a new morbidity (NM) has become a fundamental clinical outcome measure after pediatric critical illness. Data in Latin American children are still scarce.Objective : to analyze the development of new morbidities acquired after hospitalization due to Lower Respiratory Tract Infection (ITRI) in pediatric intensive care units (PICU).Patients and Method : Patients from 35 PICUs from 8 countries were included, ages 0 to 18 years with a diagnosis of ITRI, discharged alive, registered between April 2018 and September 2019, and who have required some type of ventilatory support (high-pressure system). flow, non-invasive ventilation or invasive ventilation), included in the LARed Network registry, which includes the Functional Status Scale (FSS in English) validated in the pediatric population, which assesses functional status in six domains: mental status, sensory status, communication , motor, feeding and respiratory status. NM considered ITRI after hospitalization and was defined as an increase ≥3 points in the FSS. Results : Of 3,280 children with ITRI, 85 (2.6%) developed NM, associated with diagnoses of sepsis and acute respiratory distress syndrome (ARDS), pneumococcal or adenovirus infection, infections associated with health care, and mechanical ventilation. invasive. Adenovirus infection, ARDS, and AHI were independently associated with NM. Conclusions : We observed that the development of NM upon discharge from the PICU is infrequent, but it is associated with modifiable risk factors. These data define certain risk groups for future interventions and initiatives to improve the quality of care.