Publication:

Risk factors and outcome of ventilator associated pneumonia in children aged 1 month to 12 years admitted in paediatric intensive care unit of a tertiary care hospital in Northern India

Background Ventilator-associated pneumonia (VAP) is pneumonia that occurs after the patient has been on mechanical ventilation for more than 48 hours. There is a paucity of literature depicting the severity of VAP in the North Indian population. The current study was taken up to study the risk factors and outcomes of ventilator-associated pneumonia in children aged 1 month-12 years admitted in pediatric intensive care unit (PICU).

Methods A prospective observational study was conducted in the department of pediatrics, VMMC and Safdarjung Hospital, New Delhi for 18 months. The children aged 1 month to 12 years who were mechanically ventilated in the PICU for more than 48 hours were included in the study. Demographic details, nutritional status, and underlying primary diagnosis were recorded along with details about the duration of hospital stay, ventilator days and reintubation, clinical pulmonary infection score (CPIS), and paediatric risk of mortality (PRISM) score.

Results A significant positive correlation was seen between PRISM score with duration of ventilator and hospital stay. A higher PRISM III score was found to have a significant association with the development of VAP in the patients. Duration of ventilator stay and duration of hospital stay were the major risk factors for the incidence of VAP.

Conclusions The major risk factors that contributed to the development of VAP were the duration of ventilator stay and hospital stay. PRISM III score was found as a useful tool in predicting the development of VAP in the patients. Further larger prospective and multicentric studies are required to evaluate the risk factors and outcome of VAP.