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Respiratory Support After Extubation in Children With Pediatric ARDS.
Wong, Judith Ju Ming; Tan, Herng Lee; Sultana, Rehena; Ma, Yi-Jyun; Aguilan, Apollo Bugarin; Goh, Chen Yun; Lee, Wen Cong; Kumar, Pavanish; Lee, Jan Hau.
Afiliación
  • Wong JJM; Drs Wong and Lee are affiliated with Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore; and Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore. Mss Tan, Ma, and Goh and Messrs Aguilan and Lee are affiliated w
  • Tan HL; Drs Wong and Lee are affiliated with Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore; and Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore. Mss Tan, Ma, and Goh and Messrs Aguilan and Lee are affiliated w
  • Sultana R; Drs Wong and Lee are affiliated with Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore; and Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore. Mss Tan, Ma, and Goh and Messrs Aguilan and Lee are affiliated w
  • Ma YJ; Drs Wong and Lee are affiliated with Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore; and Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore. Mss Tan, Ma, and Goh and Messrs Aguilan and Lee are affiliated w
  • Aguilan AB; Drs Wong and Lee are affiliated with Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore; and Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore. Mss Tan, Ma, and Goh and Messrs Aguilan and Lee are affiliated w
  • Goh CY; Drs Wong and Lee are affiliated with Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore; and Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore. Mss Tan, Ma, and Goh and Messrs Aguilan and Lee are affiliated w
  • Lee WC; Drs Wong and Lee are affiliated with Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore; and Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore. Mss Tan, Ma, and Goh and Messrs Aguilan and Lee are affiliated w
  • Kumar P; Drs Wong and Lee are affiliated with Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore; and Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore. Mss Tan, Ma, and Goh and Messrs Aguilan and Lee are affiliated w
  • Lee JH; Drs Wong and Lee are affiliated with Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore; and Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore. Mss Tan, Ma, and Goh and Messrs Aguilan and Lee are affiliated w
Respir Care ; 69(4): 422-429, 2024 03 27.
Article en En | MEDLINE | ID: mdl-38538015
ABSTRACT

BACKGROUND:

Postextubation respiratory support in pediatric ARDS may be used to support the recovering respiratory system and promote timely, successful liberation from mechanical ventilation. This study's aims were to (1) describe the use of postextubation respiratory support in pediatric ARDS from the time of extubation to hospital discharge, (2) identify potential risk factors for postextubation respiratory support, and (3) provide preliminary data for future larger studies.

METHODS:

This pilot single-center prospective cohort study recruited subjects with pediatric ARDS. Subjects' respiratory status up to hospital discharge, the use of postextubation respiratory support, and how it changed over time were recorded. Analysis was performed comparing subjects who received postextubation respiratory support versus those who did not and compared its use among pediatric ARDS severity categories. Multivariable logistic regression was used to determine variables associated with the use of postextubation respiratory support and included oxygenation index (OI), ventilator duration, and weight.

RESULTS:

Seventy-three subjects with pediatric ARDS, with median age and OI of 4 (0.6-10.5) y and 7.3 (4.9-12.7), respectively, were analyzed. Postextubation respiratory support was provided to 54/73 (74%)

subjects:

28/45 (62.2%), 19/21 (90.5%), and 7/7 (100%) for mild, moderate, and severe pediatric ARDS, respectively, (P = .01). OI and mechanical ventilation duration were higher in subjects who received postextubation respiratory support (8.7 [5.4-14] vs 4.6 [3.7-7], P < .001 and 10 [7-17] d vs 4 [2-7] d, P < .001) compared to those who did not. At hospital discharge, 12/67 (18.2%) survivors received home respiratory support (6 subjects died prior to hospital discharge). In the multivariable model, ventilator duration (adjusted odds ratio 1.3 [95% CI 1.0-1.7], P = .050) and weight (adjusted odds ratio 0.95 [95% CI 0.91-0.99], P = .02) were associated with the use of postextubation respiratory support.

CONCLUSIONS:

The majority of intubated subjects with pediatric ARDS received respiratory support postextubation, and a substantial proportion continued to require it up to hospital discharge.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / Extubación Traqueal Límite: Child / Humans Idioma: En Revista: Respir Care Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / Extubación Traqueal Límite: Child / Humans Idioma: En Revista: Respir Care Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos