Characteristic and outcomes of mechanical ventilated patients in pediatric icu at Tikur Anbessa referral hospital Addis Abeba, Ethiopia 2018.
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Date
2018-06
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Addis Ababa Universty
Abstract
Introduction: Mechanical ventilation (MV) is a lifesaving therapy, allowing the support of patients with respiratory failure with the objectives of improving gas exchange and decreasing work of breathing. It is mandatory for the clinicians to understand the events occurring in the pediatric intensive care unit (PICU) and outcome of mechanically ventilated children for improving the quality care of the critically ill children.
Objective: The main objective of this study is to assess the characteristics and outcomes of mechanically ventilated paediatrics patients in Tikur Anbessa referral hospital 2016- 2018.
Methodology: Cross sectional study with retrospective data collection was employed on paediatric ICU patients. Data was abstracted from the patients’ medical record by trained health professionals. SPSS version 21 software was used for analysis. The report was depicted descriptively using measures of central tendency, dispersion and displayed through tables and graphs. Bivariate and multivariate logistic regression model was fitted to identify factors associated with outcomes of ventilated patients. p value <0.05 was taken as significant.
Result: From the total of 220 cases (46.4%) from pediatrics emergency department. The commonest admission diagnosis were neurological causes 48(21.8%).The main reason for initiation of mechanical ventilation were respiratory failure 128(58.2%), malignancy was the commonest comorbidity in 39(17.7%). The preferred weaning methods was CPAP alone 54(24.5%).SIMV/PCV 176 (80.0%) was the frequently used mode. Complication occurred in 60(27.3%) of the cases. Being medical patient, cardiac and post op patients, duration on mechanical ventilation, ARDS, central nervous system failure and Higher PIM II score were significant predictors of PICU mortality.
Conclusion and recommendation: In this study mortality rate of mechanically ventilated pediatric patients was high. Respiratory failure was the main indication for initiation of mechanical ventilation. The complication rate was high. It is better to improve the quality of care and use severity score while admitting patients to PICU.
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Keywords
Mechanical ventilation, Mortality, PICU.