Title: A Prospective study on outcome following mechanical ventilation among children in a tertiary care hospital

Authors: Dr D.Sankari, Dr C.S. Balachandran, Dr S. Chidambaranathan

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.10

Abstract

Background: Mechanical ventilation (MV) in paediatric intensive care unit is a major therapeutic modality especially among children with respiratory distress and apnoea. Adequate sedation, frequent vitals monitoring, urine output are essential in titrating the ventilator settings to act in harmonious for the babies.

Methods: In total, thirty one children of age less than twelve years and greater than a year of age requiring MV comprised the study group. Pressure controlled ventilation was done initially among all the patients. Then the children were weaned to synchronized intermittent mechanical ventilation, continuous positive airway pressure and extubation done following trial of T-piece.

Results: The mean duration of mechanical ventilation was 3.65±1.64 with range from seven to one day/s.Two patients were expired on the first day of mechanical ventilation due refractory disseminated intravascular coagulation following drowning (n=3).

Discussion: Ventilator associated pneumonia, multiple organ failure, septic shock, cardiovascular insufficiency and gastrointestinal bleeding occurs frequently following MV. The frequency of these complications is lower among children under low volume and pressure settings.

Conclusion: The point prevalence of ventilator associated pneumonia was 19.35 seen in bronchiolitis (n=4) and refractory seizure (n=2). Relatively poor outcome is seen among children under MV when done for apnoea and hypoxemia.

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Corresponding Author

Dr D.Sankari

Post Graduate, Department of Pediatrics, Rajah Muthiah Medical College, Chidambaram