Division of pediatric intensive care unit, Department of Pediatrics and Child Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Department of Emergency and critical care, University of Gondar, Gondar, Ethiopia.
Ethiop J Health Sci. 2021 Sep;31(5):915-924. doi: 10.4314/ejhs.v31i5.2.
A few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources. We aimed to assess the characteristics and outcomes of mechanically ventilated pediatric patients in Tikur Anbessa Specialized Referral Hospital, Addis Ababa, Ethiopia.
A cross-sectional study was done from September 2016 to February 2018. Data were reviewed from the patients' medical records. SPSS version 21 software was used for data entry and analysis.
There were 536 patients admitted to PICU; out of these, 202 (41.2%) were on MV. Sixty-three-point six percent of the participants were males and 130 (59.1%) died. The most common indications for the initiation of MV were respiratory problems 46 (20.9%) and 30.59/1000 ventilator days developed complications. Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR= 0.13, 95% CI (0.04-0.41)] and those who have MV for more than 3 days are 79% more likely to die (p=0.003). Those who have multi-organ dysfunction syndrome (MODS) [AOR= 0.181, 95% CI (0.08, 0.412)] and high PIM II severity score [AOR= 35, 95% CI (1.7,11)] had higher mortality rate.
higher PIM II score, MODS, length of stay, and being a surgical patient increased the risk of mortality. Early resuscitation and thorough follow up of these ventilated patients are necessary.
关于机械通气（MV）在儿科重症监护病房（PICU）中的应用，非洲有一些研究。了解 MV 患者的结局对于更好地利用资源至关重要。我们旨在评估在埃塞俄比亚亚的斯亚贝巴提克里安巴萨专科医院接受机械通气的儿科患者的特征和结局。
这是一项 2016 年 9 月至 2018 年 2 月进行的横断面研究。数据来自患者的病历。使用 SPSS 版本 21 软件进行数据输入和分析。
共有 536 名患者入住 PICU；其中 202 名（41.2%）接受了 MV。63.6%的参与者为男性，130 名（59.1%）死亡。启动 MV 的最常见指征是呼吸问题 46 例（20.9%），30.59/1000 通气日发生并发症。呼吸机相关性肺炎占并发症的 18.6%，20.9/1000 通气日。内科病例的存活率优于外科病例（包括创伤）；[比值比（AOR）=0.13，95%置信区间（CI）（0.04-0.41）]和 MV 时间超过 3 天的患者死亡的可能性高 79%（p=0.003）。患有多器官功能障碍综合征（MODS）的患者 [AOR=0.181，95%CI（0.08，0.412）]和高 PIM II 严重程度评分 [AOR=35，95%CI（1.7，11）]的患者死亡率更高。
较高的 PIM II 评分、MODS、住院时间和外科患者会增加死亡率。有必要对这些接受通气的患者进行早期复苏和彻底随访。
