Mortality Rate and Causing Factors in Ventilator Associated Pneumonia in Children

Abstract

Aim: To estimate the incidence of ventilator-associated pneumonia (VAP) and to identify causing microbiological organismsand VAP related mortality rate in children admitted to the ICU. Study design: This was a Cross-sectional and an observational study. Study place and duration: In the Pediatric department of Abbasi Shaheed Hospital, Karachi, for one-year duration from May 2020 to May 2021. Methodology: All admitted children to the pediatric ICU (PICU) and ventilated were selected and observed for any features suggestive of VAP. All suspected children have Partial septic signs. A VAP will be categorized ifchild remains on ventilator for more than 48 hours and when a patient had 2 of these signs of nosocomial infection - TLC <4,000 or> 15,000 mm3 , fever> 101 ° F, CRP> 48 mg / L, neutrophils> 85% or a new chest X-rayexhibited pneumonia withradiological sign of progressive, persistent or new infiltrates. The chi-square test was used for comparison of percentages with a value of Less than 0.05 p. Results: Of all the cases admitted, the average length of ICU stay was 8.65 ± 6.45 per day. Children who needed VAP required 14.2 ±9.5 days of ventilation and 7.5± 5.2 days for children who have not VAP progression. Of 100 cohort of children necessitating ventilation, 22 died and 2 were left without advice or serious illness, with a total mortality of 22%. Conclusion: The VAP incidence in this study was 22%. Features related with a higher incidence of ventilator-associated pneumonia include age <1-year, continuous intravenous sedation and unplanned intubation in emergency situation. Features suggestive of underlying VAP encompassed, CRP> 48 mg / L, purulent tracheal secretions, positive tracheal culture of aspirate and positive X-ray results. Key words: Ventilator-associated pneumonia (VAP), Nosocomial infections,PICU and Children.