Fnu Avinash, Jeffry Nahmias, Negaar Aryan, James Jeng, Cristobal Barrios, Peter D Nguyen, Areg Grigorian
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The VAP cohort had a higher injury severity score with increased rates of traumatic brain injury (TBI) (75.3% vs. 55.4%, p < 0.001), rib fractures (24.0% vs. 16.4%, p < 0.001), and lung injuries (20.8% vs. 10.6%, p < 0.001). Independent associated risk factors for VAP included unplanned reintubation (OR 2.51, CI 1.84-3.43, p < 0.001), TBI (OR 1.96, CI 1.63-2.36, p < 0.001), and severe thoracic injury (OR 1.27, CI 1.01-1.58, p < 0.001).</p><p><strong>Conclusion: </strong>Unplanned reintubation, TBI, and severe thoracic injuries are key risk factors for VAP in intubated PTPs. Our findings highlight the need for strategies to reduce reintubation, optimize ventilator management, and improve pulmonary care in high-risk PTPs.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"216"},"PeriodicalIF":1.6000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271297/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictors of ventilator-associated pneumonia in intubated pediatric trauma patients.\",\"authors\":\"Fnu Avinash, Jeffry Nahmias, Negaar Aryan, James Jeng, Cristobal Barrios, Peter D Nguyen, Areg Grigorian\",\"doi\":\"10.1007/s00383-025-06131-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Ventilator-associated pneumonia (VAP) is the most common complication among intubated pediatric trauma patients (PTPs) in pediatric intensive care units. Early identification of associated risk factors may help mitigate adverse outcomes linked to VAP, such as increased mortality and healthcare costs. This study aims to identify risk factors associated with VAP for intubated PTPs.</p><p><strong>Methods: </strong>The 2017-2021 Trauma Quality Improvement Program database was queried for all intubated PTPs. Two groups were compared: intubated PTPs with and without VAP. Bivariate and multivariable logistic regression analyses were performed.</p><p><strong>Results: </strong>From 38,593 intubated PTPs, 819 (2.1%) developed VAP. The VAP cohort had a higher injury severity score with increased rates of traumatic brain injury (TBI) (75.3% vs. 55.4%, p < 0.001), rib fractures (24.0% vs. 16.4%, p < 0.001), and lung injuries (20.8% vs. 10.6%, p < 0.001). Independent associated risk factors for VAP included unplanned reintubation (OR 2.51, CI 1.84-3.43, p < 0.001), TBI (OR 1.96, CI 1.63-2.36, p < 0.001), and severe thoracic injury (OR 1.27, CI 1.01-1.58, p < 0.001).</p><p><strong>Conclusion: </strong>Unplanned reintubation, TBI, and severe thoracic injuries are key risk factors for VAP in intubated PTPs. Our findings highlight the need for strategies to reduce reintubation, optimize ventilator management, and improve pulmonary care in high-risk PTPs.</p><p><strong>Level of evidence: </strong>IV.</p>\",\"PeriodicalId\":19832,\"journal\":{\"name\":\"Pediatric Surgery International\",\"volume\":\"41 1\",\"pages\":\"216\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-07-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271297/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Surgery International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00383-025-06131-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Surgery International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00383-025-06131-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：呼吸机相关性肺炎（VAP）是儿科重症监护病房插管儿童创伤患者（PTPs）最常见的并发症。早期识别相关风险因素可能有助于减轻与VAP相关的不良后果，例如死亡率和医疗费用的增加。本研究旨在确定与气管插管ptp患者VAP相关的危险因素。方法：查询2017-2021年创伤质量改善计划数据库中所有插管的ptp。比较两组：有VAP和没有VAP的ptp插管。进行了双变量和多变量logistic回归分析。结果：38,593例插管PTPs中，819例（2.1%）发生VAP。VAP组损伤严重程度评分较高，创伤性脑损伤（TBI）发生率增加（75.3% vs. 55.4%）。结论：计划外再插管、TBI和严重胸部损伤是插管后ptp患者发生VAP的关键危险因素。我们的研究结果强调需要采取策略减少再插管，优化呼吸机管理，并改善高危ptp的肺部护理。证据等级：四级。
Predictors of ventilator-associated pneumonia in intubated pediatric trauma patients.
Purpose: Ventilator-associated pneumonia (VAP) is the most common complication among intubated pediatric trauma patients (PTPs) in pediatric intensive care units. Early identification of associated risk factors may help mitigate adverse outcomes linked to VAP, such as increased mortality and healthcare costs. This study aims to identify risk factors associated with VAP for intubated PTPs.
Methods: The 2017-2021 Trauma Quality Improvement Program database was queried for all intubated PTPs. Two groups were compared: intubated PTPs with and without VAP. Bivariate and multivariable logistic regression analyses were performed.
Results: From 38,593 intubated PTPs, 819 (2.1%) developed VAP. The VAP cohort had a higher injury severity score with increased rates of traumatic brain injury (TBI) (75.3% vs. 55.4%, p < 0.001), rib fractures (24.0% vs. 16.4%, p < 0.001), and lung injuries (20.8% vs. 10.6%, p < 0.001). Independent associated risk factors for VAP included unplanned reintubation (OR 2.51, CI 1.84-3.43, p < 0.001), TBI (OR 1.96, CI 1.63-2.36, p < 0.001), and severe thoracic injury (OR 1.27, CI 1.01-1.58, p < 0.001).
Conclusion: Unplanned reintubation, TBI, and severe thoracic injuries are key risk factors for VAP in intubated PTPs. Our findings highlight the need for strategies to reduce reintubation, optimize ventilator management, and improve pulmonary care in high-risk PTPs.
期刊介绍：
Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children.
The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include:
-Review articles-
Original articles-
Technical innovations-
Letters to the editor
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