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Ventilator-associated pneumonia in an Italian pediatric intensive care unit: a prospective study
Maria Francesca Patria, Giovanna Chidini, Ludovica Ughi, Cinzia Montani, Edi Prandi, Carlotta Galeone, Edoardo Calderini, Susanna Esposito
Milan, Italy
Author Affiliations: Department of Pathophysiology and Transplantation, Universit¨¤ degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (Patria MF, Esposito S); Pediatric Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (Chidini G, Ughi L, Montani C, Prandi E, Calderini E); Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy (Galeone C); Department of Occupational Health, Clinica del Lavoro Luigi Devoto, Universit¨¤ degli Studi di Milano, Milan, Italy (Galeone C)
Corresponding Author: Susanna Esposito, MD, Department of Pathophysiology and Transplantation, Universit¨¤ degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Commenda 9, 20122 Milan, Italy (Tel: +39-02-55032498; Fax: +39-02-50320206; Email: susanna.esposito@unimi.it)
doi: 10.1007/s12519-013-0444-y
Background: This study was undertaken to determine the prevalence, risk factors and outcomes associated with ventilator-associated pneumonia (VAP) in a European pediatric intensive care unit (PICU).
Methods: A total of 451 children who had been mechanically ventilated in the PICU for ¡İ48 hours during a 3-year period were enrolled in this prospective study.
Results: In comparison with children without VAP, 30 children (6.6%) who developed VAP had a longer PICU stay (P=0.0001) and hospital stay (P=0.0001), and a higher mortality rate (P=0.04). Logistic regression analysis showed that the need for re-intubation (P=0.0001), the presence of tracheostomy (P=0.04), and enteral feeding (P=0.02) were independent risk factors for VAP.
Conclusions: A relevant proportion of intubated children develop VAP, which is closely related to invasive procedures. As VAP is associated with increased medical costs and death, multicenter studies are urgently needed to improve the therapeutic approach to VAP and VAP prevention.
Key words: nosocomial infections; pneumonia; ventilator-associated pneumonia
World J Pediatr 2013;9(4):365-368
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