A Multicentered Prospective Analysis of Diagnosis, Risk Factors, and Outcomes Associated With Pediatric Ventilator-Associated Pneumonia

Sameer Gupta, Brian M. Boville, Rachel Blanton, Gloria Lukasiewicz, Jeni Wincek, Chunhong Bai, Michael L. Forbes

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

Objective: To assess risk factors and outcomes associated with pediatric ventilator-associated pneumonia. Design: Multicentered prospective observational cohort. Setting: Children's hospitals in the United States. Patients: Mechanically ventilated patients less than 18 years old. Measurements and Main Results: Prospective evaluation of the prevalence, risk factors, and outcomes of pediatric ventilator-associated pneumonia along with evaluation of diagnostic criterion for pediatric ventilator-associated pneumonia. The prevalence of pediatric ventilator-associated pneumonia was 5.2% (n = 2,082), for a rate of 7.1/1,000 ventilator days. Patients with ventilator-associated pneumonia had a longer unadjusted ICU length of stay (p < 0.0001) and increased length of mechanical ventilation by more than 11 days (p < 0.0001). After adjustment for patient factors, ICU length of stay (p = 0.03) and mechanical ventilation days (p = 0.001) remained significant. Patients with ventilator-associated pneumonia were almost three times more likely to die (p = 0.007). Independent risk factors for ventilator-associated pneumonia were reintubation and part-time ventilation. Conclusions: Pediatric ventilator-associated pneumonia is common in mechanically ventilated pediatric patients. These patients have longer length of stay, longer duration of mechanical ventilation, and increased risk for mortality.

Original languageEnglish (US)
Pages (from-to)e65-e73
JournalPediatric Critical Care Medicine
Volume16
Issue number3
DOIs
StatePublished - Mar 20 2015

Bibliographical note

Publisher Copyright:
Copyright © 2015 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

Keywords

  • hospital-acquired infections
  • pediatrics
  • pneumonia
  • ventilator-associated pneumonia

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