Risk factors for ventilator-associated pneumonia in the pediatric intensive care unit.

摘要

Background. Due to high rates of ventilator associated pneumonia (VAP) in the pediatric intensive care unit (PICU) at Rush during 2000, we sought to identify modifiable causes.;Methods. We performed a case-control study that included all 18 cases of VAP in the PICU during 2000 and 36 controls, who were PICU patients (without VAP) matched 2:1 to each case on age, sex, and admission date.;Results. Univariate analyses demonstrated significant associations between VAP and: days ventilated, parenteral and enteral nutrition, blood transfusion, heart disease, severity of illness, length of stay in the hospital, antibiotics, paralytic infusion, and H2 blockers. The best multivariable model included days ventilated (OR 1.2; P=.01) and blood transfusion (OR 5.4; P=.05).;Conclusion. The strongest predictor of VAP was number of days on a ventilator. The role of blood transfusion needs further study. Limiting days on mechanical ventilation, and possibly limiting transfusions, might minimize VAP in children.