Complications of Mechanical Ventilation in Pediatric Patients in Serbia

Abstract

Background. Mechanical ventilation is a frequently applied therapy in critically ill children and can be lifesaving in many cases. Clinical use of this technique has well documented benefits, but can be associated with different complications and adverse physiologic effects. Objectives. The aim of this study was to investigate the complications and clinical outcome of mechanical ventilation in Serbian pediatric patients. Material and Methods. The study encompassed 42 children with respiratory insufficiency that underwent mechanical ventilation during hospitalization over a period of 12 consecutive months. The influence of clinical and mechanical parameters on the occurrence of complications and clinical outcome were analyzed. Results. The patients were ventilated for a total of 432 days and a total of 61 complications were observed in 42 patients (97 complications per 1000 ventilation days). The most common complications associated with mechanical ventilation in Serbian pediatric patients with respiratory insufficiency were cardiovascular insufficiency (52.4%) and multiple organ failure (35.7%). High values of applied PIP (> 26 cm H 2 O), PEEP (> 6 cm H 2 O) and Tv (> 6 mL/kg) were associated with the occurrence of complications and negative clinical outcome. Conclusions. Complications of mechanical ventilation in the pediatric population occur frequently, but lower volumes/pressures of ventilation contribute to a decrease in incidence. Further studies are needed to examine associated risk factors and strategies to reduce the occurrence of complications and improve clinical outcome (Adv Clin Exp Med 2014, 23, 1, 57-61).

A Prospective study on outcome following mechanical ventilation among children in a tertiary care hospital

“…Ventilator associated pneumonia, multiple organ failure, septic shock, cardiovascular insufficiency and gastrointestinal bleeding occurs frequently following MV. The frequency of these complications is lower among children under low volume and pressure settings (6) . Increased in severity of the underlying diseases requiring MV is associated with higher rate of these complications.…”

Outcome of Children Treated With Invasive Mechanical Ventilation in Picu in a Tertiary Care Centre, Kerala

“…Also, majority of children were below 1 yr. of age (59.2%) and had weight below 5 kg (48%). Studies done by Tanil Kendril et al, [12] Beenish Mukhtar [13] and Snezana Rsovac et al [14] also found high incidence in male children.…”

“…Respiratory failure was the most common indication for MV in many studies. [14,15,16] Farias et al [17] in the study published in 2004 observed acute respiratory failure as the cause for initiation of invasive ventilation in 72% of the cases, whereas it was 64.8% in the study by Tanil Kendril et al [12] and 59.18% in a study from Brazil. [18] Acute pulmonary disease has been reported as the main reason for the initiation of MV in developing countries, whereas postoperative state seems to be the main indication for ventilatory support in developed countries.…”

“…[20,21] Mean duration of mechanical ventilation in our study was 5.1 ± 5.24 days. Mean duration of mechanical ventilation in Snezana Rsovac et al [14] and Tania Principi et al [12] were 8.9 and 3.1 days, respectively.…”

“…Majority of cases in the present study presented late in the advanced state of disease. In the studies by Beenish Mukhtar et al [13] and Snezana Rsovac et al, [14] mortalities were 30.3% and 38% respectively. The most likely explanation for lower rate is that in the study by Beenish Mukhtar et al from Pakistan, acute neurological illnesses (35.8%) was the most common indication of MV and also adoption of non-invasive ventilation in the early phases of acute respiratory illness as initial mode of respiratory support, both contributing to low mortality.…”