Longer duration of mechanical ventilation was found to be associated with ventilator-associated pneumonia in children aged 1 month to 12 years in India

Awasthi, Sanjay; Tahazzul, Mohammad; Ambast, Ankur; Govil, Y. C.; Jain, Amita

doi:10.1016/j.jclinepi.2012.06.006

Cited by 41 publications

(52 citation statements)

References 24 publications

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“…9,10 Additionally, use of aseptic technique may not be possible during emergency invasive procedures because of the critical nature of the situation. 18 In a study in India, 19 reintubation within 72 hours of extubation was asssociated with an increased tendency for the development of VAP. In our study, emergency reintubation was a significant risk factor for VAP.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Ventilator-Associated Pneumonia in Infants and Children: a Cross-sectional Cohort Study

Kusahara

Enz

Avelar

et al. 2014

American Journal of Critical Care

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BackgroundThe epidemiology of ventilator-associated pneumonia is well described for adults, but little information is available on risk factors for this disease in children. Objective To identify predisposing factors for ventilatorassociated pneumonia in children. Methods A cross-sectional prospective cohort study of 96 patients in a 9-bed pediatric intensive care unit was performed. Variables examined were demographic characteristics, inpatient care, medications, nutrition, invasive procedures, and characteristics of mechanical ventilation. Data were analyzed by using Pearson χ 2 analysis, Fisher exact and Mann-Whitney tests, odds ratios, and forward stepwise logistic regression. Results Occurrence of ventilator-associated pneumonia correlated positively with use of nasoenteral tubes (odds ratio, 5.278; P < .001), intermittent administration of nutritional formula (odds ratio, 6.632; P = .005), emergency reintubation (odds ratio, 2.700; P = .02), use of vasoactive drugs (odds ratio, 5.108; P = .009), duration of mechanical ventilation (P < .001), and length of stay in the pediatric intensive care unit (P < .001) and in the hospital (P = .01). Conclusion Use of vasoactive drugs, presence of a nasoenteral tube, and duration of stay in the pediatric intensive care unit were independent risk factors for ventilator-associated pneumonia.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Ventilator-Associated Pneumonia in Infants and Children: a Cross-sectional Cohort Study

Kusahara

Enz

Avelar

et al. 2014

American Journal of Critical Care

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“…[15][16][17] It was reported that the prolonged mechanical ventilation could prolong the hospital and intensive care unit (ICU) stay, 18) increase the burden of patients, and raise the risk of cerebral palsy, postoperative atrial fibrillation or ventilator-associated pneumonia. [19][20][21] Thus, it is necessary to reduce the duration of mechanical ventilation in patients requiring prolonged mechanical ventilation.…”

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confidence: 99%

Early Rehabilitation Therapy Is Beneficial for Patients With Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery

Dong

Zhang

et al. 2016

Int. Heart J.

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SummaryWe investigated the effects of early rehabilitation therapy on prolonged mechanically ventilated patients after coronary artery bypass surgery (CABG).A total of 106 patients who underwent CABG between June 2012 and May 2015 were enrolled and randomly assigned into an early rehabilitation group (53 cases) and a control group (53 cases). The rehabilitation therapy consisted of 6 steps including head up, transferring from supination to sitting, sitting on the edge of bed, sitting in a chair, transferring from sitting to standing, and walking along a bed. The patients received rehabilitation therapy in the intensive care unit (ICU) after CABG in the early rehabilitation group. The control group patients received rehabilitation therapy after leaving the ICU.The results showed that the early rehabilitation therapy could significantly decrease the duration of mechanical ventilation (early rehabilitation group: 8.1 ± 3.3 days; control group: 13.9 ± 4.1 days, P < 0.01), hospital stay (early rehabilitation group: 22.0 ± 3.8 days; control group: 29.1 ± 4.6 days, P < 0.01), and ICU stay (early rehabilitation group: 11.7 ± 3.2 days; control group: 18.3 ± 4.2 days, P < 0.01) for patients requiring more than 72 hours prolonged mechanical ventilation. The results of Kaplan-Meier analysis showed that the proportions of patients remaining on mechanical ventilation in the early rehabilitation group were larger than that in the control group after 7 days of rehabilitation therapy (logrank test: P < 0.01).The results provide evidence for supporting the application of early rehabilitation therapy in patients requiring prolonged mechanical ventilation after CABG. (Int Heart J 2016; 57: 241-246) Key words: Postoperative recovery, Hospital stay, Randomized controlled trial, Intensive care unit C oronary artery disease is the primary cause of death worldwide. 1) Coronary artery bypass surgery (CABG) is commonly used for patients with severe coronary artery disease at the left anterior descending artery, circumflex artery, and right coronary artery.2,3) Cardiac rehabilitation is used for improving functional capacity and reducing cardiovascular mortality and morbidity in patients undergoing CABG. [4][5][6] Previous studies have shown that rehabilitation therapy could significantly reduce the length of hospitalization time, costs and complications, promote cardiac function recovery, and improve the quality of life in patients who underwent CABG. [7][8][9][10][11] Mechanical ventilation was routinely applied after CABG to reduce the power consumption of the respiratory system and the cardiac burden to improve postoperative cardiac recovery. [12][13][14] Due to a system of risk factors (such as the duration of surgery, anesthesia, clinical condition, mode of ventilator therapy, and method of weaning from mechanical ventilation), many patients should receive prolonged mechanical ventilation. [15][16][17] It was reported that the prolonged mechanical ventilation could prolong the hospital and intensive care unit (ICU) stay, 18) incre...

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“…A similar review revealed higher rates in lower-center salary contrasted with upper-center wage nations. Significantly high incidences were observed from India i.e., 36.2% and Egypt as 31.8/1000 ventilator-days [12,13]. While a lower frequency was reported from USA and Germany [14][15][16].…”

Section: Ventilator-associated Pneumonia (Vap) In Children and Neonatesmentioning

confidence: 91%

“…Pathophysiology of VAP is classified as the respiratory and digestive regions colonization and secreted micro aspiration of superior and inferior segments of airway [12]. Initiation of VAP is categorized into 2 forms: a) Rapid onset: VAP associated with antibiotic-susceptible species and occurs within 48-96 h after intubation.…”

Section: Pathophysiology Of Vapmentioning

confidence: 99%

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Ventilator-Associated Pneumonia (VAP): Clinical Strategies, Treatment Challenges and Economic Concerns

Zubair¹,

Ali²,

Zafar³

et al. 2017

J Bioequiv Availab

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Longer duration of mechanical ventilation was found to be associated with ventilator-associated pneumonia in children aged 1 month to 12 years in India

Cited by 41 publications

References 24 publications

Risk Factors for Ventilator-Associated Pneumonia in Infants and Children: a Cross-sectional Cohort Study

Risk Factors for Ventilator-Associated Pneumonia in Infants and Children: a Cross-sectional Cohort Study

Early Rehabilitation Therapy Is Beneficial for Patients With Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery

Ventilator-Associated Pneumonia (VAP): Clinical Strategies, Treatment Challenges and Economic Concerns

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