Incidence and factors associated with prolonged use of mechanical ventilation in pediatric intensive care unit in a single tertiary care hospital.

Introduction: Invasive mechanical ventilation (IMV) is frequently used as a life-supporting device in Pediatric Intensive Care Units (PICU). To date, there are few studies evaluating the impact of prolonged mechanical ventilation (PMV) in children which is associated with high morbidity and mortality. We aimed to determine the incidence and factors associated with PMV in PICU at our institution.

Methods: A retrospective review was performed of children aged 1 month to 18 years who were admitted to the PICU at Chiang Mai University Hospital, Thailand between January and December 2020. PMV was defined if the duration of IMV was ≥ 96 hours. Baseline characteristics and factors associated with PMV were analyzed by descriptive statistics, and univariable and multivariable logistic regression analysis, respectively. A p-value of < 0.05 was considered significant.

Results: Ninety-two episodes of IMV were performed in 90 children. The median (IQR) age of the children was 22.8 (7.2-111.9) months (male 64.1%). Forty-six of 92 (50%) children received PMV and 32.6% of children with PMV required a tracheostomy. Following multivariable analysis, factors associated with PMV were age <2 years old (OR 2.86, 95% CI 1.04-7.84, p = 0.041), male gender (OR 3.21, 95% CI 1.15-8.94, p = 0.026), and multiple antibiotics administration during PICU admission (OR 7.83, 95% CI 1.87-32.78, p = 0.005), respectively.

Conclusions: Pediatric PMV was notably common, with younger age, male gender, and multiple antibiotic use contributing to higher risk. Developing weaning protocols and strategies to reduce PMV duration is crucial.