某三级医院儿童重症监护病房机械通气患儿的临床概况及预后

Dr. N Sathyadith, Dr. M Sucindar, Dr. S Ramesh
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摘要

背景:机械通气是指用于辅助通气和供氧的人工方法。随着机械通气的出现,儿科重症监护患者的成功率更高,并发症管理更好,预后改善,死亡率和发病率降低。本研究旨在评估某三级医院收治的农村人口机械通气儿童的前述危险因素、适应证、临床特征和转归。方法:对某三级医院儿童重症监护室2个月~ 12岁需要机械通气的危重患儿进行前瞻性观察研究。收集的数据包括流行病学资料、危险因素、临床、实验室和机械通气资料。结果:共有70名儿童需要机械通气,平均±SD年龄为2.05±2.4岁。支气管肺炎是最常见的诊断(n=20, 28.6%),研究参与者中最常见的机械通气指征是严重呼吸窘迫(n=23, 32.9%)。在研究参与者中观察到的最常见并发症是呼吸机相关性肺炎(n= 21,30 %)。总体而言,大多数参与者存活(n=44, 62.9%),而26名参与者(37.1%)在本研究中死亡。结论:以1岁以下儿童居多,社会经济状况较差。呼吸系统疾病如支气管肺炎和细支气管炎是需要机械通气的常见疾病。未来需要更多的分析研究来评估机械通气儿童的长期后遗症和预后。
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Clinical profile and outcome of mechanically ventilated children in pediatric intensive care unit at a tertiary care hospital
Background: Mechanical ventilation refers to artificial methods used for supporting ventilation and oxygenation. With the advent of mechanical ventilation, the intensive care for pediatric patients have witnessed high success rates, better management of complications and improved outcomes with reduced mortality and morbidity rates. This study was done to assess the preceding risk factors, indication, clinical profile and outcome of mechanically ventilated children from rural population admitted in a tertiary care hospital. Methods: Prospective observational study of critically ill cchildren between 2 months and 12 years of age who required mechanical ventilation in Pediatric Intensive Care Unit of a tertiary care hospital. The data collected includes epidemiological profile, risk factors, clinical, laboratory and mechanical ventilation profile. Results: A total of 70 children required mechanical ventilation .The mean ± SD age of the participants was 2.05 ±2.4 years. Bronchopneumonia was the most common diagnosis (n=20, 28.6%) and the most common indication for mechanical ventilation among the study participants was severe respiratory distress (n=23, 32.9%).The most common complication observed among the study participants was Ventilator associated pneumonia (n=21, 30%). Overall, majority of the participants survived (n=44, 62.9%) while 26 (37.1%) participants expired in this study. Conclusion: Majority of the children were less than 1 year of age from poor socio economic status. Respiratory causes like bronchopneumonia and bronchiolitis were the common conditions requiring mechanical ventilation. More analytical studies are needed in future, to estimate the long term sequelae and outcome in mechanically ventilated children.
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