Original Article

Complications of mechanical ventilation in the pediatric population

Tania Principi MD

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Douglas D. Fraser MD, PhD,

Douglas D. Fraser MD, PhD

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

Children's Health Research Institute, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Gavin C. Morrison MD,

Gavin C. Morrison MD

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Sami Al Farsi MD,

Sami Al Farsi MD

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Jose F. Carrelas RRT,

Jose F. Carrelas RRT

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Elizabeth A. Maurice BSc, RRT,

Elizabeth A. Maurice BSc, RRT

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Alik Kornecki MD,

Corresponding Author

Alik Kornecki MD

[email protected]

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

Children's Health Research Institute, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

Pediatric Critical Care Unit, Children's Hospital, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario, Canada N6A 5W9.Search for more papers by this author

Tania Principi MD,

Tania Principi MD

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Douglas D. Fraser MD, PhD,

Douglas D. Fraser MD, PhD

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

Children's Health Research Institute, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Gavin C. Morrison MD,

Gavin C. Morrison MD

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Sami Al Farsi MD,

Sami Al Farsi MD

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Jose F. Carrelas RRT,

Jose F. Carrelas RRT

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Elizabeth A. Maurice BSc, RRT,

Elizabeth A. Maurice BSc, RRT

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

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Alik Kornecki MD,

Corresponding Author

Alik Kornecki MD

[email protected]

Critical Care Unit, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

Children's Health Research Institute, Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

Pediatric Critical Care Unit, Children's Hospital, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario, Canada N6A 5W9.Search for more papers by this author

First published: 30 December 2010

https://doi.org/10.1002/ppul.21389

Citations: 66

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Abstract

Background

Mechanical ventilation (MV) strategies are continuously evolving in an effort to minimize adverse events. The objective of this study was to determine the complications associated with MV in children.

Study Design

Prospective observational study. Over a period of 10 consecutive months, 150 patients (median age 0.8 years, IQR 4.4, 59% male) were enrolled in this study.

Results

The median duration of MV was 3.1 days (IQR 3.9). A total of 85 complications were observed in 60 (40%) patients (114 complications per 1,000 ventilation days). 16.7% of patients developed atelectasis, 13.3% post-extubation stridor, 9.3% failed extubation, 2.0% pneumothorax, 3.3% accidental extubation, 2.7% nasal or perioral tissue damage and 1.9% ventilator associated pneumonia. Atelectasis occurred most often in the left lower lobe (36%) or in the right upper lobe (26%). The incidence of atelectasis in children <1 year of age was 12% (31 episodes per 1,000 days of ventilation) compared to 18% (57 episodes per 1,000 days of ventilation) in children ≥1 year of age (P < 0.05). Patients that failed extubation were ventilated for a median of 8.5 (IQR 8.8) days compared to 2.9 days (IQR, 3.8) in patients that were successfully extubated (P < 0.01). The absence of an air leak prior to extubation did not correlate with failed extubation. Accidental extubation was limited to orally intubated patients.

Conclusion

MV complications occurred in 40% of patients and most often consisted of atelectasis and post-extubation stridor. Further studies are needed to examine associated risk factors and strategies to reduce their occurrence. Pediatr Pulmonol. 2011; 46:452–457. © 2010 Wiley-Liss, Inc.

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Volume46, Issue5

May 2011

Pages 452-457

Complications of mechanical ventilation in the pediatric population

Abstract

Background

Study Design

Results

Conclusion

REFERENCES

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References

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Complications of mechanical ventilation in the pediatric population

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Background

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