Ventilator-associated events in children: A multicentre prospective cohort study
•Ventilator-associated pneumonia surveillance shifted to ventilator-associated event.•No paediatric definition of ventilator-associated event has been properly validated.•A definition based on slight increases of PEEP/FiO2 was the least restrictive.•It was also the only independently associated with...
Gespeichert in:
| Veröffentlicht in: | Anaesthesia critical care & pain medicine 2022-06, Vol.41 (3), p.101072-101072, Article 101072 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 101072 |
|---|---|
| container_issue | 3 |
| container_start_page | 101072 |
| container_title | Anaesthesia critical care & pain medicine |
| container_volume | 41 |
| creator | Peña-López, Yolanda Campins-Martí, Magda Slöcker-Barrio, Maria Bustinza, Amaya Alejandre, Carme Jordán-García, Iolanda Ortiz-Álvarez, Ana López-Castilla, Jose Domingo Pérez, Elena Schüffelmann, Cristina García-Besteiro, María Sánchez-Pérez, Silvia Arjona, David Coca-Pérez, Ana De Carlos, Juan Carlos Flores-González, Jose Carlos Mendizabal, Mikel Sánchez-Granados, Jose Manuel Martínez-Padilla, María Carmen Pérez, Rosalía Abril-Molina, Ana Tejada, Sofia Roca, David Serrano-Megías, Marta Rello, Jordi |
| description | •Ventilator-associated pneumonia surveillance shifted to ventilator-associated event.•No paediatric definition of ventilator-associated event has been properly validated.•A definition based on slight increases of PEEP/FiO2 was the least restrictive.•It was also the only independently associated with worse outcomes in children.
The Centres for Disease Control and Prevention (CDC) broadened the focus of surveillance from ventilator-associated pneumonia to ventilator-associated event (VAE) for quality purposes. No paediatric definition of VAE (PaedVAE) has been accurately validated. We aimed to analyse the incidence and impact on patient outcomes resulting from the application of the adult and two paediatric VAE (PaedVAE) criteria. Secondary objective: to evaluate VAE/PaedVAE as factors associated with increased duration of mechanical ventilation (MV) and Paediatric Intensive Care Unit (PICU) stay.
Multicentre observational prospective cohort study in 15 PICUs in Spain. VAEs were assessed using the 2013/2015 CDC classification. PaedVAE were assessed using the CDC definition based on mean airway pressure (MAP-PaedVAE) versus a paediatric definition based on positive end-expiratory pressure (PEEP-PaedVAE). Children who underwent MV ≥ 48 h were included.
A total of 3626 ventilator-days in 391 patients were analysed. The incidence of VAE, MAP-PaedVAE and PEEP-PaedVAE was 8.55, 5.24 and 20.96 per 1000 ventilator-days, respectively. The median time [IQR] for VAE, MAP-PaedVAE and PEEP-PaedVAE development from the MV onset was 4 [3–12.5], 4 [3–14], and 5 [3–7.75] days, respectively. Among survivors, all three were associated with increased MV duration (> 7 days) and PICU stay (> 10 days) at univariate analysis. Multivariate analysis showed that PEEP-PaedVAE was the only definition independently associated with MV above 7 days [OR = 4.86, 95% CI (2.41–10.11)] and PICU stay [OR = 3.49, 95% CI (1.68–7.80)] above ten days, respectively.
A VAE definition based on slight PEEP increases should be preferred for VAE surveillance in children. |
| doi_str_mv | 10.1016/j.accpm.2022.101072 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2656742990</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2352556822000534</els_id><sourcerecordid>2656742990</sourcerecordid><originalsourceid>FETCH-LOGICAL-c359t-84cc1a3fd9dee82073d5fd177d6ff6eacf903c7e915b8b25085d472718cb31703</originalsourceid><addsrcrecordid>eNp9kE1LAzEQhoMotmh_gSB79LI1H5vNruChiF9Q0IN6DelklqbsR02yhf57t7aKJ08zzLwz78xDyAWjU0ZZfr2aGoB1M-WU812FKn5ExlxInkqZF8d_8hGZhLCilLIsV6JUp2QkZKYUpeWYvH5gG11tYudTE0IHzkS0CW6Gckhcm8DS1dZje5PMkqavo4Oh4zFZ-y6sEaLbYALdsvMxCbG323NyUpk64OQQz8j7w_3b3VM6f3l8vpvNUxCyjGmRATAjKltaxIJTJaysLFPK5lWVo4GqpAIUlkwuigWXtJA2U1yxAhaCKSrOyNV-73DIZ48h6sYFwLo2LXZ90DyXucp4We6kYi-F4ebgsdJr7xrjt5pRvaOpV_qbpt7R1Huaw9TlwaBfNGh_Z37YDYLbvQCHNzcOvQ7gsAW0zg9gtO3cvwZfyCWHKg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2656742990</pqid></control><display><type>article</type><title>Ventilator-associated events in children: A multicentre prospective cohort study</title><source>Alma/SFX Local Collection</source><creator>Peña-López, Yolanda ; Campins-Martí, Magda ; Slöcker-Barrio, Maria ; Bustinza, Amaya ; Alejandre, Carme ; Jordán-García, Iolanda ; Ortiz-Álvarez, Ana ; López-Castilla, Jose Domingo ; Pérez, Elena ; Schüffelmann, Cristina ; García-Besteiro, María ; Sánchez-Pérez, Silvia ; Arjona, David ; Coca-Pérez, Ana ; De Carlos, Juan Carlos ; Flores-González, Jose Carlos ; Mendizabal, Mikel ; Sánchez-Granados, Jose Manuel ; Martínez-Padilla, María Carmen ; Pérez, Rosalía ; Abril-Molina, Ana ; Tejada, Sofia ; Roca, David ; Serrano-Megías, Marta ; Rello, Jordi</creator><creatorcontrib>Peña-López, Yolanda ; Campins-Martí, Magda ; Slöcker-Barrio, Maria ; Bustinza, Amaya ; Alejandre, Carme ; Jordán-García, Iolanda ; Ortiz-Álvarez, Ana ; López-Castilla, Jose Domingo ; Pérez, Elena ; Schüffelmann, Cristina ; García-Besteiro, María ; Sánchez-Pérez, Silvia ; Arjona, David ; Coca-Pérez, Ana ; De Carlos, Juan Carlos ; Flores-González, Jose Carlos ; Mendizabal, Mikel ; Sánchez-Granados, Jose Manuel ; Martínez-Padilla, María Carmen ; Pérez, Rosalía ; Abril-Molina, Ana ; Tejada, Sofia ; Roca, David ; Serrano-Megías, Marta ; Rello, Jordi ; the EUVAE-Kids Study Investigators Group ; EUVAE-Kids Study Investigators Group</creatorcontrib><description>•Ventilator-associated pneumonia surveillance shifted to ventilator-associated event.•No paediatric definition of ventilator-associated event has been properly validated.•A definition based on slight increases of PEEP/FiO2 was the least restrictive.•It was also the only independently associated with worse outcomes in children.
The Centres for Disease Control and Prevention (CDC) broadened the focus of surveillance from ventilator-associated pneumonia to ventilator-associated event (VAE) for quality purposes. No paediatric definition of VAE (PaedVAE) has been accurately validated. We aimed to analyse the incidence and impact on patient outcomes resulting from the application of the adult and two paediatric VAE (PaedVAE) criteria. Secondary objective: to evaluate VAE/PaedVAE as factors associated with increased duration of mechanical ventilation (MV) and Paediatric Intensive Care Unit (PICU) stay.
Multicentre observational prospective cohort study in 15 PICUs in Spain. VAEs were assessed using the 2013/2015 CDC classification. PaedVAE were assessed using the CDC definition based on mean airway pressure (MAP-PaedVAE) versus a paediatric definition based on positive end-expiratory pressure (PEEP-PaedVAE). Children who underwent MV ≥ 48 h were included.
A total of 3626 ventilator-days in 391 patients were analysed. The incidence of VAE, MAP-PaedVAE and PEEP-PaedVAE was 8.55, 5.24 and 20.96 per 1000 ventilator-days, respectively. The median time [IQR] for VAE, MAP-PaedVAE and PEEP-PaedVAE development from the MV onset was 4 [3–12.5], 4 [3–14], and 5 [3–7.75] days, respectively. Among survivors, all three were associated with increased MV duration (> 7 days) and PICU stay (> 10 days) at univariate analysis. Multivariate analysis showed that PEEP-PaedVAE was the only definition independently associated with MV above 7 days [OR = 4.86, 95% CI (2.41–10.11)] and PICU stay [OR = 3.49, 95% CI (1.68–7.80)] above ten days, respectively.
A VAE definition based on slight PEEP increases should be preferred for VAE surveillance in children.</description><identifier>ISSN: 2352-5568</identifier><identifier>EISSN: 2352-5568</identifier><identifier>DOI: 10.1016/j.accpm.2022.101072</identifier><identifier>PMID: 35477009</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Children ; Mechanical ventilation ; PICU ; Quality improvement ; Ventilator-associated event</subject><ispartof>Anaesthesia critical care & pain medicine, 2022-06, Vol.41 (3), p.101072-101072, Article 101072</ispartof><rights>2022 Société française d’anesthésie et de réanimation (Sfar)</rights><rights>Copyright © 2022 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-84cc1a3fd9dee82073d5fd177d6ff6eacf903c7e915b8b25085d472718cb31703</citedby><cites>FETCH-LOGICAL-c359t-84cc1a3fd9dee82073d5fd177d6ff6eacf903c7e915b8b25085d472718cb31703</cites><orcidid>0000-0003-0676-6210 ; 0000-0002-3475-1721 ; 0000-0001-5381-4858 ; 0000-0002-4503-1607 ; 0000-0002-9914-1123 ; 0000-0001-6094-4474 ; 0000-0002-6394-8398 ; 0000-0001-5320-1007 ; 0000-0002-4913-1365 ; 0000-0002-2000-6587</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35477009$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peña-López, Yolanda</creatorcontrib><creatorcontrib>Campins-Martí, Magda</creatorcontrib><creatorcontrib>Slöcker-Barrio, Maria</creatorcontrib><creatorcontrib>Bustinza, Amaya</creatorcontrib><creatorcontrib>Alejandre, Carme</creatorcontrib><creatorcontrib>Jordán-García, Iolanda</creatorcontrib><creatorcontrib>Ortiz-Álvarez, Ana</creatorcontrib><creatorcontrib>López-Castilla, Jose Domingo</creatorcontrib><creatorcontrib>Pérez, Elena</creatorcontrib><creatorcontrib>Schüffelmann, Cristina</creatorcontrib><creatorcontrib>García-Besteiro, María</creatorcontrib><creatorcontrib>Sánchez-Pérez, Silvia</creatorcontrib><creatorcontrib>Arjona, David</creatorcontrib><creatorcontrib>Coca-Pérez, Ana</creatorcontrib><creatorcontrib>De Carlos, Juan Carlos</creatorcontrib><creatorcontrib>Flores-González, Jose Carlos</creatorcontrib><creatorcontrib>Mendizabal, Mikel</creatorcontrib><creatorcontrib>Sánchez-Granados, Jose Manuel</creatorcontrib><creatorcontrib>Martínez-Padilla, María Carmen</creatorcontrib><creatorcontrib>Pérez, Rosalía</creatorcontrib><creatorcontrib>Abril-Molina, Ana</creatorcontrib><creatorcontrib>Tejada, Sofia</creatorcontrib><creatorcontrib>Roca, David</creatorcontrib><creatorcontrib>Serrano-Megías, Marta</creatorcontrib><creatorcontrib>Rello, Jordi</creatorcontrib><creatorcontrib>the EUVAE-Kids Study Investigators Group</creatorcontrib><creatorcontrib>EUVAE-Kids Study Investigators Group</creatorcontrib><title>Ventilator-associated events in children: A multicentre prospective cohort study</title><title>Anaesthesia critical care & pain medicine</title><addtitle>Anaesth Crit Care Pain Med</addtitle><description>•Ventilator-associated pneumonia surveillance shifted to ventilator-associated event.•No paediatric definition of ventilator-associated event has been properly validated.•A definition based on slight increases of PEEP/FiO2 was the least restrictive.•It was also the only independently associated with worse outcomes in children.
The Centres for Disease Control and Prevention (CDC) broadened the focus of surveillance from ventilator-associated pneumonia to ventilator-associated event (VAE) for quality purposes. No paediatric definition of VAE (PaedVAE) has been accurately validated. We aimed to analyse the incidence and impact on patient outcomes resulting from the application of the adult and two paediatric VAE (PaedVAE) criteria. Secondary objective: to evaluate VAE/PaedVAE as factors associated with increased duration of mechanical ventilation (MV) and Paediatric Intensive Care Unit (PICU) stay.
Multicentre observational prospective cohort study in 15 PICUs in Spain. VAEs were assessed using the 2013/2015 CDC classification. PaedVAE were assessed using the CDC definition based on mean airway pressure (MAP-PaedVAE) versus a paediatric definition based on positive end-expiratory pressure (PEEP-PaedVAE). Children who underwent MV ≥ 48 h were included.
A total of 3626 ventilator-days in 391 patients were analysed. The incidence of VAE, MAP-PaedVAE and PEEP-PaedVAE was 8.55, 5.24 and 20.96 per 1000 ventilator-days, respectively. The median time [IQR] for VAE, MAP-PaedVAE and PEEP-PaedVAE development from the MV onset was 4 [3–12.5], 4 [3–14], and 5 [3–7.75] days, respectively. Among survivors, all three were associated with increased MV duration (> 7 days) and PICU stay (> 10 days) at univariate analysis. Multivariate analysis showed that PEEP-PaedVAE was the only definition independently associated with MV above 7 days [OR = 4.86, 95% CI (2.41–10.11)] and PICU stay [OR = 3.49, 95% CI (1.68–7.80)] above ten days, respectively.
A VAE definition based on slight PEEP increases should be preferred for VAE surveillance in children.</description><subject>Children</subject><subject>Mechanical ventilation</subject><subject>PICU</subject><subject>Quality improvement</subject><subject>Ventilator-associated event</subject><issn>2352-5568</issn><issn>2352-5568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LAzEQhoMotmh_gSB79LI1H5vNruChiF9Q0IN6DelklqbsR02yhf57t7aKJ08zzLwz78xDyAWjU0ZZfr2aGoB1M-WU812FKn5ExlxInkqZF8d_8hGZhLCilLIsV6JUp2QkZKYUpeWYvH5gG11tYudTE0IHzkS0CW6Gckhcm8DS1dZje5PMkqavo4Oh4zFZ-y6sEaLbYALdsvMxCbG323NyUpk64OQQz8j7w_3b3VM6f3l8vpvNUxCyjGmRATAjKltaxIJTJaysLFPK5lWVo4GqpAIUlkwuigWXtJA2U1yxAhaCKSrOyNV-73DIZ48h6sYFwLo2LXZ90DyXucp4We6kYi-F4ebgsdJr7xrjt5pRvaOpV_qbpt7R1Huaw9TlwaBfNGh_Z37YDYLbvQCHNzcOvQ7gsAW0zg9gtO3cvwZfyCWHKg</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Peña-López, Yolanda</creator><creator>Campins-Martí, Magda</creator><creator>Slöcker-Barrio, Maria</creator><creator>Bustinza, Amaya</creator><creator>Alejandre, Carme</creator><creator>Jordán-García, Iolanda</creator><creator>Ortiz-Álvarez, Ana</creator><creator>López-Castilla, Jose Domingo</creator><creator>Pérez, Elena</creator><creator>Schüffelmann, Cristina</creator><creator>García-Besteiro, María</creator><creator>Sánchez-Pérez, Silvia</creator><creator>Arjona, David</creator><creator>Coca-Pérez, Ana</creator><creator>De Carlos, Juan Carlos</creator><creator>Flores-González, Jose Carlos</creator><creator>Mendizabal, Mikel</creator><creator>Sánchez-Granados, Jose Manuel</creator><creator>Martínez-Padilla, María Carmen</creator><creator>Pérez, Rosalía</creator><creator>Abril-Molina, Ana</creator><creator>Tejada, Sofia</creator><creator>Roca, David</creator><creator>Serrano-Megías, Marta</creator><creator>Rello, Jordi</creator><general>Elsevier Masson SAS</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0676-6210</orcidid><orcidid>https://orcid.org/0000-0002-3475-1721</orcidid><orcidid>https://orcid.org/0000-0001-5381-4858</orcidid><orcidid>https://orcid.org/0000-0002-4503-1607</orcidid><orcidid>https://orcid.org/0000-0002-9914-1123</orcidid><orcidid>https://orcid.org/0000-0001-6094-4474</orcidid><orcidid>https://orcid.org/0000-0002-6394-8398</orcidid><orcidid>https://orcid.org/0000-0001-5320-1007</orcidid><orcidid>https://orcid.org/0000-0002-4913-1365</orcidid><orcidid>https://orcid.org/0000-0002-2000-6587</orcidid></search><sort><creationdate>20220601</creationdate><title>Ventilator-associated events in children: A multicentre prospective cohort study</title><author>Peña-López, Yolanda ; Campins-Martí, Magda ; Slöcker-Barrio, Maria ; Bustinza, Amaya ; Alejandre, Carme ; Jordán-García, Iolanda ; Ortiz-Álvarez, Ana ; López-Castilla, Jose Domingo ; Pérez, Elena ; Schüffelmann, Cristina ; García-Besteiro, María ; Sánchez-Pérez, Silvia ; Arjona, David ; Coca-Pérez, Ana ; De Carlos, Juan Carlos ; Flores-González, Jose Carlos ; Mendizabal, Mikel ; Sánchez-Granados, Jose Manuel ; Martínez-Padilla, María Carmen ; Pérez, Rosalía ; Abril-Molina, Ana ; Tejada, Sofia ; Roca, David ; Serrano-Megías, Marta ; Rello, Jordi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-84cc1a3fd9dee82073d5fd177d6ff6eacf903c7e915b8b25085d472718cb31703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Children</topic><topic>Mechanical ventilation</topic><topic>PICU</topic><topic>Quality improvement</topic><topic>Ventilator-associated event</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peña-López, Yolanda</creatorcontrib><creatorcontrib>Campins-Martí, Magda</creatorcontrib><creatorcontrib>Slöcker-Barrio, Maria</creatorcontrib><creatorcontrib>Bustinza, Amaya</creatorcontrib><creatorcontrib>Alejandre, Carme</creatorcontrib><creatorcontrib>Jordán-García, Iolanda</creatorcontrib><creatorcontrib>Ortiz-Álvarez, Ana</creatorcontrib><creatorcontrib>López-Castilla, Jose Domingo</creatorcontrib><creatorcontrib>Pérez, Elena</creatorcontrib><creatorcontrib>Schüffelmann, Cristina</creatorcontrib><creatorcontrib>García-Besteiro, María</creatorcontrib><creatorcontrib>Sánchez-Pérez, Silvia</creatorcontrib><creatorcontrib>Arjona, David</creatorcontrib><creatorcontrib>Coca-Pérez, Ana</creatorcontrib><creatorcontrib>De Carlos, Juan Carlos</creatorcontrib><creatorcontrib>Flores-González, Jose Carlos</creatorcontrib><creatorcontrib>Mendizabal, Mikel</creatorcontrib><creatorcontrib>Sánchez-Granados, Jose Manuel</creatorcontrib><creatorcontrib>Martínez-Padilla, María Carmen</creatorcontrib><creatorcontrib>Pérez, Rosalía</creatorcontrib><creatorcontrib>Abril-Molina, Ana</creatorcontrib><creatorcontrib>Tejada, Sofia</creatorcontrib><creatorcontrib>Roca, David</creatorcontrib><creatorcontrib>Serrano-Megías, Marta</creatorcontrib><creatorcontrib>Rello, Jordi</creatorcontrib><creatorcontrib>the EUVAE-Kids Study Investigators Group</creatorcontrib><creatorcontrib>EUVAE-Kids Study Investigators Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anaesthesia critical care & pain medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peña-López, Yolanda</au><au>Campins-Martí, Magda</au><au>Slöcker-Barrio, Maria</au><au>Bustinza, Amaya</au><au>Alejandre, Carme</au><au>Jordán-García, Iolanda</au><au>Ortiz-Álvarez, Ana</au><au>López-Castilla, Jose Domingo</au><au>Pérez, Elena</au><au>Schüffelmann, Cristina</au><au>García-Besteiro, María</au><au>Sánchez-Pérez, Silvia</au><au>Arjona, David</au><au>Coca-Pérez, Ana</au><au>De Carlos, Juan Carlos</au><au>Flores-González, Jose Carlos</au><au>Mendizabal, Mikel</au><au>Sánchez-Granados, Jose Manuel</au><au>Martínez-Padilla, María Carmen</au><au>Pérez, Rosalía</au><au>Abril-Molina, Ana</au><au>Tejada, Sofia</au><au>Roca, David</au><au>Serrano-Megías, Marta</au><au>Rello, Jordi</au><aucorp>the EUVAE-Kids Study Investigators Group</aucorp><aucorp>EUVAE-Kids Study Investigators Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ventilator-associated events in children: A multicentre prospective cohort study</atitle><jtitle>Anaesthesia critical care & pain medicine</jtitle><addtitle>Anaesth Crit Care Pain Med</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>41</volume><issue>3</issue><spage>101072</spage><epage>101072</epage><pages>101072-101072</pages><artnum>101072</artnum><issn>2352-5568</issn><eissn>2352-5568</eissn><abstract>•Ventilator-associated pneumonia surveillance shifted to ventilator-associated event.•No paediatric definition of ventilator-associated event has been properly validated.•A definition based on slight increases of PEEP/FiO2 was the least restrictive.•It was also the only independently associated with worse outcomes in children.
The Centres for Disease Control and Prevention (CDC) broadened the focus of surveillance from ventilator-associated pneumonia to ventilator-associated event (VAE) for quality purposes. No paediatric definition of VAE (PaedVAE) has been accurately validated. We aimed to analyse the incidence and impact on patient outcomes resulting from the application of the adult and two paediatric VAE (PaedVAE) criteria. Secondary objective: to evaluate VAE/PaedVAE as factors associated with increased duration of mechanical ventilation (MV) and Paediatric Intensive Care Unit (PICU) stay.
Multicentre observational prospective cohort study in 15 PICUs in Spain. VAEs were assessed using the 2013/2015 CDC classification. PaedVAE were assessed using the CDC definition based on mean airway pressure (MAP-PaedVAE) versus a paediatric definition based on positive end-expiratory pressure (PEEP-PaedVAE). Children who underwent MV ≥ 48 h were included.
A total of 3626 ventilator-days in 391 patients were analysed. The incidence of VAE, MAP-PaedVAE and PEEP-PaedVAE was 8.55, 5.24 and 20.96 per 1000 ventilator-days, respectively. The median time [IQR] for VAE, MAP-PaedVAE and PEEP-PaedVAE development from the MV onset was 4 [3–12.5], 4 [3–14], and 5 [3–7.75] days, respectively. Among survivors, all three were associated with increased MV duration (> 7 days) and PICU stay (> 10 days) at univariate analysis. Multivariate analysis showed that PEEP-PaedVAE was the only definition independently associated with MV above 7 days [OR = 4.86, 95% CI (2.41–10.11)] and PICU stay [OR = 3.49, 95% CI (1.68–7.80)] above ten days, respectively.
A VAE definition based on slight PEEP increases should be preferred for VAE surveillance in children.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>35477009</pmid><doi>10.1016/j.accpm.2022.101072</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-0676-6210</orcidid><orcidid>https://orcid.org/0000-0002-3475-1721</orcidid><orcidid>https://orcid.org/0000-0001-5381-4858</orcidid><orcidid>https://orcid.org/0000-0002-4503-1607</orcidid><orcidid>https://orcid.org/0000-0002-9914-1123</orcidid><orcidid>https://orcid.org/0000-0001-6094-4474</orcidid><orcidid>https://orcid.org/0000-0002-6394-8398</orcidid><orcidid>https://orcid.org/0000-0001-5320-1007</orcidid><orcidid>https://orcid.org/0000-0002-4913-1365</orcidid><orcidid>https://orcid.org/0000-0002-2000-6587</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2352-5568 |
| ispartof | Anaesthesia critical care & pain medicine, 2022-06, Vol.41 (3), p.101072-101072, Article 101072 |
| issn | 2352-5568 2352-5568 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2656742990 |
| source | Alma/SFX Local Collection |
| subjects | Children Mechanical ventilation PICU Quality improvement Ventilator-associated event |
| title | Ventilator-associated events in children: A multicentre prospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T08%3A57%3A50IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ventilator-associated%20events%20in%20children:%20A%20multicentre%20prospective%20cohort%20study&rft.jtitle=Anaesthesia%20critical%20care%20&%20pain%20medicine&rft.au=Pe%C3%B1a-L%C3%B3pez,%20Yolanda&rft.aucorp=the%20EUVAE-Kids%20Study%20Investigators%20Group&rft.date=2022-06-01&rft.volume=41&rft.issue=3&rft.spage=101072&rft.epage=101072&rft.pages=101072-101072&rft.artnum=101072&rft.issn=2352-5568&rft.eissn=2352-5568&rft_id=info:doi/10.1016/j.accpm.2022.101072&rft_dat=%3Cproquest_cross%3E2656742990%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2656742990&rft_id=info:pmid/35477009&rft_els_id=S2352556822000534&rfr_iscdi=true |