OUTCOME OF CHILDREN TREATED WITH INVASIVE MECHANICAL VENTILATION IN PICU IN A TERTIARY CARE CENTRE, KERALA

• Published in: Journal of evolution of medical and dental sciences Vol. 7; no. 19; pp. 2342 - 2346
• Main Authors: Shanmugham, G, Rajesh T.V, Babu, Francis C.V, Jayakrishnan, M.P
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 07.05.2018
• Subjects: Analysis; Children; Health aspects; Mechanical ventilation; Treatment outcome; India
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2018/528

BACKGROUND Mechanical ventilation (MV) has become one of the major indications for admission to paediatric ICUs and often a lifesaving strategy. However, use of MV can be associated with various complications including patient's mortality. Management of children with invasive ventilation necessitates facility for intensive monitoring as well as supportive care, which is challenging in a limited resource setup. Aims and Objectives--The study aimed to assess the clinical profile and outcome of children treated with invasive mechanical ventilation. MATERIALS AND METHODS A prospective cohort study conducted in the PICU of the Department of Paediatrics, Government Medical College, Kozhikode during the period of January 2014 to June 2015. Clinical details of children given invasive mechanical ventilation for more than 24 hours were analysed. RESULTS Study group included 130 children, 54.6% males and mean age of 27 months. Most had respiratory diseases with other comorbid conditions. Respiratory failure (62.3%) was the most common indication for MV followed by airway protection (28.5%) and persistent shock (9.2%). Most common initial ventilatory mode used was SIMV. Mean (SD) duration of ventilation was 5.1 (5.24) days. Reintubation was required in 59.2% children, mostly due to ET tube obstruction. Among 130 children, 63 children (48.5%) developed a total of 116 complications equating to 175 complications per 1,000 days of ventilation. Failed extubation (22.3%), VAP (16.9%) and post extubation stridor (13.8%) were the common complications. Total mortality was 54.6% and majority were infants. Pneumonia with sepsis (54.8%) was the admitting diagnosis in most of those expired. Duration of MV, prolonged requirement of higher FiO2 and development of complications were associated with mortality. CONCLUSION Prolonged duration of ventilation was significantly associated with complications as well as mortality related to mechanical ventilation. High rate mortality occurred in infants and in those with underlying chronic diseases. KEY WORDS Mechanical Ventilation, Bronchopneumonia, Respiratory Failure, Ventilator Associated Pneumonia, Atelectasis, Complications, Clinical Outcome.