CLINICORADIOLOGIC EVALUATION OF VENTILATOR ASSOCIATED PNEUMONIA IN PEDIATRIC INTENSIVE CARE UNIT OF A TERTIARY CENTER

2018 ◽  
Author(s):  
Ayper Somer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Ventilator Associated Pneumonia ◽  
Tertiary Center

Weaning From Noninvasive Ventilatory Support in Infants With Severe Bronchiolitis: An Observational Study

2021 ◽  
Author(s):  
Julie Cassibba ◽  
Claire Freycon ◽  
Julia Doutau ◽  
Isabelle Pin ◽  
Alexandre Bellier ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Pediatric Intensive Care Unit ◽  
Positive Airway Pressure ◽  
Ventilatory Support ◽  
Winter Season ◽  
Pediatric Intensive Care ◽  
High Flow Nasal Cannula ◽  
Tertiary Center

Abstract Background: The aim of the study was to analyze the weaning success, the type of weaning procedures, and weaning duration in consecutive infants hospitalized over a winter season in a Pediatric Intensive Care Unit.Methods: A retrospective observational study in a pediatric intensive care unit in a tertiary center. Infants hospitalized for a severe bronchiolitis were included and the weaning procedure from continuous positive airway pressure (CPAP), noninvasive ventilation (NIV) or high flow nasal cannula (HFNC) was analyzed.Results: Data from 95 infants (median age 47 days) were analyzed. On admission, 26 (27%), 46 (49%) and 23 (24%) infants were supported by CPAP, NIV and HFNC, respectively. One (4%), nine (20%) and one (4%) infants failed weaning while supported by CPAP, NIV or HFNC, respectively (p=0.1). In infants supported by CPAP, CPAP was stopped directly in 5 patients (19%) while HFNC was used as an intermediate ventilatory support in 21 (81%). The duration of weaning was shorter for HFNC (17 hours, [IQR 0-26]) than for CPAP (24 hours, [14-40]) and NIV (28 hours, [19-49]) (p<0.01).Conclusions: The weaning phase represent a large proportion of noninvasive ventilatory support duration in infants with bronchiolitis. The weaning procedure following a “step down” strategy may lead to an increase in duration of weaning.

Interprofessional Approach to the Sustained Reduction in Ventilator-Associated Pneumonia in a Pediatric Intensive Care Unit

2018 ◽  
Vol 38 (6) ◽  
pp. 36-45 ◽  
Author(s):  
Cheryl Lynne McBeth ◽  
Rosa Solis Montes ◽  
Amy Powne ◽  
Sopon Elizabeth North ◽  
JoAnne E. Natale
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Ventilator Associated Pneumonia ◽  
Sustained Reduction

scholarly journals Ventilator-Associated Pneumonia in Neonatal and Pediatric Intensive Care Unit Patients

2007 ◽  
Vol 20 (3) ◽  
pp. 409-425 ◽  
Author(s):  
Elizabeth Foglia ◽  
Mary Dawn Meier ◽  
Alexis Elward
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Antibiotic Use ◽  
Educational Interventions ◽  
Empiric Therapy ◽  
Attributable Mortality ◽  
Ventilator Associated Pneumonia ◽  
Case Control Studies

SUMMARY Ventilator-associated pneumonia (VAP) is the second most common hospital-acquired infection among pediatric intensive care unit (ICU) patients. Empiric therapy for VAP accounts for approximately 50% of antibiotic use in pediatric ICUs. VAP is associated with an excess of 3 days of mechanical ventilation among pediatric cardiothoracic surgery patients. The attributable mortality and excess length of ICU stay for patients with VAP have not been defined in matched case control studies. VAP is associated with an estimated $30,000 in attributable cost. Surveillance for VAP is complex and usually performed using clinical definitions established by the CDC. Invasive testing via bronchoalveolar lavage increases the sensitivity and specificity of the diagnosis. The pathogenesis in children is poorly understood, but several prospective cohort studies suggest that aspiration and immunodeficiency are risk factors. Educational interventions and efforts to improve adherence to hand hygiene for children have been associated with decreased VAP rates. Studies of antibiotic cycling in pediatric patients have not consistently shown this measure to prevent colonization with multidrug-resistant gram-negative rods. More consistent and precise approaches to the diagnosis of pediatric VAP are needed to better define the attributable morbidity and mortality, pathophysiology, and appropriate interventions to prevent this disease.

Ventilator-Associated Pneumonia in the Pediatric Intensive Care Unit: Characterizing the Problem and Implementing a Sustainable Solution

2009 ◽  
Vol 154 (4) ◽  
pp. 582-587.e2 ◽  
Author(s):  
Michael T. Bigham ◽  
Rick Amato ◽  
Pattie Bondurrant ◽  
Jon Fridriksson ◽  
Catherine D. Krawczeski ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Ventilator Associated Pneumonia
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