Experience in a Pediatric Prolonged Mechanical Ventilation Unit from a public hospital in Chile.

Abstract

Hospitalized patients with high respiratory technology dependency are increasingly common and result in lengthy stays in intensive care units. Strategies mitigating its impact have been scarcely described. To describe a 6-year experience in a Pediatric Prolonged Mechanical Ventilation Unit. Retrospective study. All children admitted to the unit between October 2012 and December 2018 were included. Descriptive and inferential statistical methods were used, analyzing lengths of stay and readmissions. Different outcome measures were compared according to the type of pathology and mechanical ventilation. A total of 113 patients had 310 admissions to the unit. Age at admission: 2.2 years (0.6-8.8); males: 60.2 %. neuromuscular disease (22.1 %), chronic lung disease (20.4 %), neurological damage (34.5 %), upper airway obstruction (9.7 %), heart disease (3.5 %), Down syndrome (9.7 %). A total of 10 507 bed-days were used; with a 92.6 % occupancy rate, 54.8 % of transfers to the intensive care unit, and 66.1 % of readmissions. Mean length of stay: 16 days (6.5- 49.0); differences in age at admission observed by pathology (p = 0.032). More readmissions were observed in children with neurological damage and Down syndrome (p = 0.004). Children with invasive ventilation were observed to have a longer length of stay (p < 0.001) and more readmissions (p < 0.001). The occupancy rate at the PMVU was over 90 %, which allowed more available intensive care beds and discharging all patients. Children with invasive ventilation had a longer length of stay and more readmissions.