Abstract：Objective To investigate the differences in clinical characteristics among children on prolonged mechanical ventilation (PMV) due to different primary diseases. Methods A retrospective analysis was performed on the clinical data of 59 pediatric patients requiring PMV from July 2017 to September 2022. According to the primary disease, they were divided into respiratory disease (RD) group, central nervous system (CNS) group, neuromuscular disease (NMD) group, and other disease group. The four groups were compared in terms of general information, treatment, and outcome. Results There were significant differences among the four groups in age, body weight, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score, Pediatric Risk of Mortality III (PRISM Ⅲ) score, analgesic and sedative treatment, nutrition supply, rehabilitation treatment, tracheotomy, successful ventilator weaning, and outcomes ( P<0.05). Compared with the RD group, the CNS group and the other disease group had a significantly higher age and a significantly higher proportion of children receiving rehabilitation treatment, and the CNS group had a significantly higher proportion of children receiving tracheotomy ( P<0.008). Compared with the other disease group, the CNS group and the NMD group had significantly lower PELOD-2 and PRISM III scores, and the CNS group had a significantly higher proportion of children with successful ventilator weaning and a significantly higher proportion of children who were improved and discharged ( P<0.008). Conclusions There are differences in clinical characteristics among children receiving PMV due to different etiologies. Most children in the RD group have a younger age, and children in the CNS group have a relatively good prognosis.
ZHU Jun-Zhen,LI Zheng,CUI Li-Dan et al. Clinical characteristics of children on prolonged mechanical ventilation due to different primary diseases[J]. CJCP, 2024, 26(5): 481-485.
Sch?nhofer B, Geiseler J, Dellweg D, et al . Prolonged weaning: S2k guideline published by the German Respiratory Society[J]. Respiration, 2021, 99( 11): 982- 1084. PMID: 33302267. DOI: 10.1159/000510085 .
Pavone M, Verrillo E, Onofri A, et al . Characteristics and outcomes in children on long-term mechanical ventilation: the experience of a pediatric tertiary center in Rome[J]. Ital J Pediatr, 2020, 46( 1): 12. PMID: 32005269. PMCID: PMC6995086. DOI: 10.1186/s13052-020-0778-8 .
Chau SK, Yung AW, Lee SL . Long-term management for ventilator-assisted children in Hong Kong: 2 decades' experience[J]. Respir Care, 2017, 62( 1): 54- 64. PMID: 27899532. DOI: 10.4187/respcare.04989 .
Zhang Z, Tao J, Cai X, et al . Clinical characteristics and outcomes of children with prolonged mechanical ventilation in PICUs in mainland China: a national survey[J]. Pediatr Pulmonol, 2023, 58( 5): 1401- 1410. PMID: 36705329. DOI: 10.1002/ppul.26332 .
Nathan AM, Loo HY, de Bruyne JA, et al . Thirteen years of invasive and noninvasive home ventilation for children in a developing country: a retrospective study[J]. Pediatr Pulmonol, 2017, 52( 4): 500- 507. PMID: 27712049. DOI: 10.1002/ppul.23569 .
Sauthier M, Rose L, Jouvet P . Pediatric prolonged mechanical ventilation: considerations for definitional criteria[J]. Respir Care, 2017, 62( 1): 49- 53. PMID: 27879381. DOI: 10.4187/respcare.04881 .
Mehta NM, Skillman HE, Irving SY, et al . Guidelines for the provision and assessment of nutrition support therapy in the pediatric critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition[J]. Pediatr Crit Care Med, 2017, 18( 7): 675- 715. PMID: 28691958. DOI: 10.1097/PCC.0000000000001134 .
Dokken M, Rust?en T, Stubhaug A . Indirect calorimetry reveals that better monitoring of nutrition therapy in pediatric intensive care is needed[J]. JPEN J Parenter Enteral Nutr, 2015, 39( 3): 344- 352. PMID: 24255088. DOI: 10.1177/0148607113511990 .
Li XJ, You XY, Wang CY, et al . Bidirectional brain-gut-microbiota axis in increased intestinal permeability induced by central nervous system injury[J]. CNS Neurosci Ther, 2020, 26( 8): 783- 790. PMID: 32472633. PMCID: PMC7366750. DOI: 10.1111/cns.13401 .
Hov B, Andersen T, Toussaint M, et al . User-perceived impact of long-term mechanical assisted cough in paediatric neurodisability[J]. Dev Med Child Neurol, 2023, 65( 5): 655- 663. PMID: 36787316. DOI: 10.1111/dmcn.15543 .
Tanaka A, Uchiyama A, Kitamura T, et al . Association between early tracheostomy and patient outcomes in critically ill patients on mechanical ventilation: a multicenter cohort study[J]. J Intensive Care, 2022, 10( 1): 19. PMID: 35410403. PMCID: PMC8996211. DOI: 10.1186/s40560-022-00610-x .
22 Karamyshau AM, Leonau AV, Shcharbakova PA, et al . Tracheostomy as a component of intensive care for central nervous system diseases[J]. Health and Ecol Issues, 2023, 19( 4): 35- 41. DOI: 10.51523/2708-6011.2022-19-4-05 .
