Document Type : Original Article
Authors
Department of Pediatrics, Faculty of Medicine, Aswan University
Abstract
Abstract
Background: Around fifty-five percent of pediatric intensive care unit (ICU) admissions necessitate mechanical ventilation (MV). The extubation and intubation of such cases are significant risks and may correlate with elevated morbidity and mortality rates.
Aim: To assess the magnitude of extubation failure of mechanically ventilated cases admitted to pediatric ICU at Aswan University Hospital and to study different factors related to extubation failure.
Methods: This prospective cohort research has performed in the PICU of the Pediatric Department at Aswan University Hospital, Aswan, Egypt, over a six-month period from June 2022 to December 2022. All admitted cases in this period have been involved in the research.
Results: This research analyzed 50 pediatric ICU cases, of which 20 (40%) experienced extubation failure. No significant differences were found in sex, age, or diagnosis. Extubation failure was significantly associated with intubation >1 week (73.91%, p<0.001), hospital stays >2 weeks (62.5%, p=0.03), absence of pre-extubation steroids (80%, p<0.001), VAP (82.35%, p<0.001), positive CRP (70.83%, p<0.001), ETT/blood culture growth (92.31%, p<0.001), severe oxygenation index (p=0.006), mechanical complications (p=0.002), cardiopulmonary arrest (p=0.006), electrolyte imbalances (p<0.001), and sedation >5 days (76.19%, p<0.001). Pre-extubation steroid use and addressing risk factors may reduce extubation failure.
Conclusion: Extubation failure is linked to prolonged intubation, hospital stay, VAP, mechanical complications, high oxygenation index, sedation, electrolyte imbalance, and cardiopulmonary arrest; corticosteroids may help prevent it.
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