Risk factors of ventilator-associated pneumonia in children in an Egyptian University Children’s Hospital

Abstract

Aim To evaluate the risk factors that contribute to the development of ventilator-associated pneumonia (VAP) in children. Settings and design A prospective observational study was conducted. The study was done in pediatric intensive care unit (PICU) at Mansoura University Children’s Hospital, Egypt, over 1 year. The study included 154 patients. Patients and methods Many variables were analyzed such as demographic characteristics; previous hospital and PICU admission; drugs used such as inotropes, steroids, sedatives, H2 blockers, or proton pump inhibitors; nutritional therapies; chronic illnesses; invasive procedures such as central line insertion; duration of mechanical ventilation (MV); and PICU stay before development of VAP. Statistical analysis used All patients were assessed by Pediatric Risk of Mortality Score III in the first 24 h and evaluated for VAP by daily clinical examination and by radiological and laboratory evaluation. Results Duration of MV and PICU stay (before development of VAP) markedly increased the incidence of VAP (P value for both was <0.001). Steroid and sedative increased the incidence of VAP significantly (P=0.001 and 0.007, respectively). Conclusions Use of steroids and sedatives, prolonged MV, and length of PICU stay are the main risk factors that contribute toward the increased risk of VAP development in Mansoura University Children’s Hospital intensive care.