Abstract:
BACKGROUND:The objective of this study was to determine factors predictive of need for mechanical ventilation (MV) upon discharge from the pediatric intensive care unit (PICU) among patients who receive a tracheostomy during their stay. METHODS:This was a retrospective cohort study using the Virtual PICU Systems (VPS) database. Patients <18 years old admitted between 2009-2011 who required MV for at least 3 days and received a tracheostomy during their PICU stay were included. RESULTS:A total of 680 pediatric patients from 74 PICUs were included, of whom 347 (51%) remained on MV at the time of PICU discharge. Neonates (30/38, 79%) and infants (129/203, 64%) required MV at PICU discharge after tracheostomy more often than adolescents (66/141, 47%) and children (122/298, 41%). Time on MV pre-tracheostomy was longer among those who required MV at discharge (median 18.3 vs. 13.8 days, P < 0.0001); however, number of failed extubations was similar (median 1 for both groups, P = 0.97). On mixed-effects multivariable regression analysis, the age categories of neonate (OR 2.9, 95%CI 1.1-7.6, P = 0.03), and infant (OR 1.7, 95%CI 1.1-2.8, P = 0.03), and ventilator days prior to tracheostomy (OR 1.01, 95%CI 1.0-1.02, P = 0.01) were significantly associated with increased odds of MV upon PICU discharge, while being a trauma admission was associated with decreased odds (OR 0.45, 95%CI 0.28-0.73, P = 0.001). CONCLUSIONS:Younger patients and those with prolonged courses of MV prior to tracheostomy are more likely to continue to need MV upon PICU discharge.
journal_name
Pediatr Pulmonoljournal_title
Pediatric pulmonologyauthors
McCrory MC,Lee KJ,Scanlon MC,Wakeham MKdoi
10.1002/ppul.23195subject
Has Abstractpub_date
2016-01-01 00:00:00pages
53-9issue
1eissn
8755-6863issn
1099-0496journal_volume
51pub_type
杂志文章abstract::Plastic bronchitis (PB) is an uncommon, potentially fatal disease, marked by endobronchial cast formation causing variable degrees of respiratory distress. Primary and secondary pulmonary lymphatic abnormalities have been identified among the underlying mechanisms of cast formation. We present a case of PB where lymph...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.22673
更新日期:2013-05-01 00:00:00
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journal_title:Pediatric pulmonology
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journal_title:Pediatric pulmonology
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journal_title:Pediatric pulmonology
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abstract::Our objective was to determine whether a simple method of maintaining positive pressure ventilation during nonbronchoscopic bronchoalveolar lavage (NB-BAL) would successfully reduce the incidence and/or severity of desaturation events. Our design was a clinical trial with historical controls. Seventy ventilated pediat...
journal_title:Pediatric pulmonology
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更新日期:2004-09-01 00:00:00
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journal_title:Pediatric pulmonology
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journal_title:Pediatric pulmonology
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journal_title:Pediatric pulmonology
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journal_title:Pediatric pulmonology
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更新日期:2008-11-01 00:00:00
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journal_title:Pediatric pulmonology
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更新日期:2018-04-01 00:00:00
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journal_title:Pediatric pulmonology
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journal_title:Pediatric pulmonology
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更新日期:2011-02-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.20735
更新日期:2008-01-01 00:00:00
abstract::Oxygen supplementation may improve exercise tolerance and the physiological response to exercise in cystic fibrosis (CF) patients. Elevated barometric pressure at low altitude is a simple means of increasing the quantity of inspired oxygen. Our objectives were to examine the effect of natural oxygen enrichment (at the...
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pub_type: 杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2018-07-01 00:00:00
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journal_title:Pediatric pulmonology
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更新日期:2020-03-01 00:00:00
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journal_title:Pediatric pulmonology
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更新日期:2006-05-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 临床试验,杂志文章
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更新日期:1995-11-01 00:00:00
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journal_title:Pediatric pulmonology
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更新日期:2019-06-01 00:00:00
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更新日期:2009-10-01 00:00:00
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更新日期:2021-01-22 00:00:00