RISK score for developing ventilator‐associated pneumonia in children: The RISVAP study

Abstract

Objectives Ventilator‐associated pneumonia (VAP) is the second most common healthcare‐associated infection in children. The aim of this study was to determine the risk factors for VAP in children and to create a risk score for developing VAP (RISVAP score). Study design It was a prospective observational study, including children who required mechanical ventilation (MV), registered in the multicentre ENVIN‐HELICS database from 2014 to 2019. The regression coefficients of each independent risk factor for VAP were used to create the RISVAP score. Each factor scored 0 if it was absent, or, if it was present, an assigned value from 1 to 7, according to the regression coefficient. Results A total of 3798 patients were included, 97(2.5%) developing VAP. The independent risk factors for VAP were: female (odds ratio [OR]: 1.642, p = 0.024), MV > 4 days (OR: 26.79, p < 0.001), length in pediatric intensive care unit > 7 days (OR: 11.74, p < 0.001), and previous colonisation (OR: 4.18, p < 0.001). The RISVAP was calculated for each patient as the sum of all the independent risk factors. Three risk groups were obtained: low (0–5 points), intermediate (6–12 points), and high risk for VAP (13–16 points). The area under the curve for the final score was 0.905 (95%confidence interval: 0.888–0.923, p < 0.001). Conclusions The RISVAP is the first risk score for VAP in pediatric populations. Using this predictive score, might be helpful to detect vulnerable patients and therefore implement preventative strategies.

A Research Study on Prompt Results and Physical Assessment of Mechanically Ventilated Children

“…In a few reported examples, mechanical ventilation lasted for 4-6 days. [29,30] In our PICU, mechanical ventilation lasted a median of four days. More than 10 days of ventilator support were needed by 11.8%.…”

Evaluation of the combined predictive value of multiple indicators based on diaphragmatic ultrasound using logistic regression and ROC curve in weaning from mechanical ventilation in pediatric patients

“…In the Pediatric Intensive Care Unit (PICU), mechanical ventilation is a commonly used life-support intervention for children with respiratory failure ( 1 ). However, prolonged mechanical ventilation can lead to pulmonary complications such as ventilator-associated pneumonia and lung injury ( 2 , 3 ). Therefore, safely and timely weaning from mechanical ventilation poses a significant challenge for clinical pediatricians.…”