Complications during mechanical ventilation—A pediatric intensive care perspective

Sood, Shawn; Ganatra, Hammad A.; Marques, Francesca Perez; Langner, Travis R.

doi:10.3389/fmed.2023.1016316

Cited by 5 publications

(4 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A life support system like MV is a factor that is monitored and kept under control until the recovery cycle starts. An increased duration of MV further becomes more challenging if other ventilatorassociated complications arise [14].…”

Section: Need and Duration Of MVmentioning

confidence: 99%

Impact of malnutrition on the outcome of critically-ill children: A comprehensive narrative review

Agrawal,

Agrawal

2024

Indian J Child Health

View full text Add to dashboard Cite

Malnutrition presents a universal challenge, affecting millions of children and resulting in severe health consequences. Notably, its consequences within the pediatric population, especially those that necessitate admission to the pediatric intensive care unit (PICU), are of concern. This narrative review discusses the nutritional status, particularly malnutrition, and factors associated that impact the outcome during the PICU stay. Furthermore, the interpretation of clinical conditions and physiological aspects and the understanding of potential interventions together help to analyze the outcome associated with malnutrition. By studying these aspects, this review proposes to contribute a proper understanding of how malnutrition closely influences outcomes in the condition of children admitted to PICUs.

show abstract

Section: Need and Duration Of MVmentioning

confidence: 99%

Impact of malnutrition on the outcome of critically-ill children: A comprehensive narrative review

Agrawal,

Agrawal

2024

Indian J Child Health

View full text Add to dashboard Cite

show abstract

“…The advent of mechanical ventilation has revolutionized the care of critically ill neonates, enabling the survival of those with severe respiratory distress. However, the mechanical ventilation of neonates is not without its challenges and risks, particularly concerning the development of neurological complications [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of Neutrophil-to-Monocyte Ratio, Lymphocyte-to-Monocyte Ratio, C-Reactive Protein, Procalcitonin, and Tumor Necrosis Factor Alpha for Neurological Complications in Mechanically Ventilated Neonates Born after 35 Weeks of Gestation

Cioboata,

Boia,

Manea

et al. 2024

Pediatric Reports

View full text Add to dashboard Cite

This prospective study investigated the association between elevated neutrophil-to-monocyte ratio (NMR), lymphocyte-to-monocyte ratio (LMR), C-reactive protein (CRP), procalcitonin, and tumor necrosis factor-alpha (TNF-alpha) and the risk of developing neurological complications in mechanically ventilated neonates. The aim was to evaluate these biomarkers’ predictive value for neurological complications. Within a one-year period from January to December 2022, this research encompassed neonates born at ≥35 weeks of gestational age who required mechanical ventilation in the neonatal intensive care unit (NICU) from the first day of life. Biomarkers were measured within the first 24 h and at 72 h. Sensitivity, specificity, and area under the curve (AUC) values were calculated for each biomarker to establish the best cutoff values for predicting neurological complications. The final analysis included a total of 85 newborns, of which 26 developed neurological complications and 59 without such complications. Among the studied biomarkers, TNF-alpha at >12.8 pg/mL in the first 24 h demonstrated the highest predictive value for neurological complications, with a sensitivity of 82%, specificity of 69%, and the highest AUC (0.574, p = 0.005). At 72 h, TNF-alpha levels greater than 14.3 pg/mL showed further increased predictive accuracy (sensitivity of 87%, specificity of 72%, AUC of 0.593, p < 0.001). The NMR also emerged as a significant predictor, with a cutoff value of >5.3 yielding a sensitivity of 78% and specificity of 67% (AUC of 0.562, p = 0.029) at 24 h, and a cutoff of >6.1 showing a sensitivity of 76% and specificity of 68% (AUC of 0.567, p = 0.025) at 72 h. Conversely, CRP and procalcitonin showed limited predictive value at both time points. This study identifies TNF-alpha and NMR as robust early predictors of neurological complications in mechanically ventilated neonates, underscoring their potential utility in guiding early intervention strategies. These findings highlight the importance of incorporating specific biomarker monitoring in the clinical management of at-risk neonates to mitigate the incidence of neurological complications.

show abstract

“…[4][5][6] In addition, invasive ventilation is associated with atelectasis, pneumothorax, ICU neuromyopathy, vocal cord paralysis, tissue damage, and ICU delirium. 7 Historically, nutrition has often been withheld when children with bronchiolitis are receiving NIV because of two concerns:…”

Section: Introductionmentioning

confidence: 99%

“…In some studies on infants with bronchiolitis, high‐flow nasal cannula (HFNC) and continuous positive airway pressure (CPAP) have been shown to reduce the need for intubation by up to 30%, thus decreasing the risk of adverse effects, such as ventilator‐associated pneumonia and prolonged hospital stay 4–6 . In addition, invasive ventilation is associated with atelectasis, pneumothorax, ICU neuromyopathy, vocal cord paralysis, tissue damage, and ICU delirium 7 …”

Section: Introductionmentioning

confidence: 99%

Association between goal nutrition and intubation in patients with bronchiolitis on noninvasive ventilation: A retrospective cohort study

Huq,

Pareek,

Stowe

et al. 2023

J Parenter Enteral Nutr

View full text Add to dashboard Cite

BackgroundAcute bronchiolitis causes many hospitalizations in children under 2 years old. Early enteral nutrition is associated with improved outcomes in these patients. However, often nutrition is withheld when patients require non‐invasive respiratory support, due to risk of aspiration worsening respiratory failure, possibly requiring intubation. We hypothesize that achieving goal calories is associated with lower intubation rate in hospitalized children with bronchiolitis who require non‐invasive ventilation.MethodsThis retrospective cohort study examined the association between goal enteral nutrition (60% of dietary reference caloric intake) and intubation rates. We grouped patients by severity of illness and compared intubation rates in those who met goal calories to those who did not. We use stratified analysis methods (for both level of respiratory support and feeding route) to evaluate progression to intubation. Results:Of the 272 patients, 215 met goal feeds. These groups had similar demographics, but the goal feeds group started on higher respiratory support in the PICU. We found that 4.65% of the patients who met goal feeds required intubation compared to 24.6% of patients who did not meet goal feeds (p<0.0001), even after controlling for respiratory status at admission and time of feed initiation and feeding route.ConclusionWe observed when adjusting for severity, feeding route, and respiratory support, achieving goal calories remained associated with a lower rate of intubation, without higher rates of aspiration. Confounding factors include practice variation and difference in severity of illness that objective scoring may have missed.This article is protected by copyright. All rights reserved.

show abstract

Complications during mechanical ventilation—A pediatric intensive care perspective

Cited by 5 publications

References 40 publications

Impact of malnutrition on the outcome of critically-ill children: A comprehensive narrative review

Impact of malnutrition on the outcome of critically-ill children: A comprehensive narrative review

Predictive Value of Neutrophil-to-Monocyte Ratio, Lymphocyte-to-Monocyte Ratio, C-Reactive Protein, Procalcitonin, and Tumor Necrosis Factor Alpha for Neurological Complications in Mechanically Ventilated Neonates Born after 35 Weeks of Gestation

Association between goal nutrition and intubation in patients with bronchiolitis on noninvasive ventilation: A retrospective cohort study

Contact Info

Product

Resources

About