Early outcome of mechanical ventilation in pediatric surgery patients.

Abstract

Objective: To report early outcome of mechanical ventilation in pediatric surgical patients. Study Design: Retrospective Analytical Cross-sectional study. Setting: Pediatric Surgical Intensive Unit, Mayo Hospital/ King Edward Medical University, Lahore. Period: January 2020 to December 2020. Material & Methods: The patients requiring mechanical ventilation were included, while patients requiring non-invasive ventilation (CPAP), or with cardiac anomalies and pneumonia were excluded. Demographic variables, diagnosis, source of ICU admission, mechanical ventilation setting and cause of mechanical initiation was recorded. Outcome noted were mortality and morbidity, sepsis, ventilator associated pneumonia (VAP), and ventilator associated lung injury (VILI). For pneumonia and sepsis, vancomycin and meropenem was started, while for VILI chest intubation was done. Results: Total numbers of children enrolled in study were 60. Mean age of the patient was 14.6±3.8 months. Mean weight was 6.3±0.99 kg. Mean number of days on mechanical ventilation were 1.8±0.3 days. Mean length of hospital stay was 7.9±1.2 days. There were 35 patients (58.3%) on Synchronus mode (SIMV) group, and 25 patients (41.7%) on control mode (A/C, pressure) group. Mortality was noted in 39 (65%) children, while 21 (35%) children survived. Thirteen (21.7%) children developed VAP, while 40(66.7%) developed sepsis. VILI was noted in 12 (20%) children. No association was seen between mortality and sepsis, VAP, VILI. Conclusion: If initiated at the right time, mechanical ventilation is not only useful but also life-saving. However, to prevent complications like VAP, VILI early weaning off is mandatory. Mortality was noted in 65% children, while 21.7% developed VAP, 66.7% developed sepsis, and 20% suffered from VILI.