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Master Thesis

Évaluation de l’incidence des pneumopathies acquises sous ventilation mécanique en réanimation pédiatrique

Abstract : Objective: Evaluate ventilator-associated pneumonia (VAP) incidence in our pediatric intensive care unit (PICU) and risk factors. Design: A single-center retrospective study.:Setting: PICU of Grenoble Alpes university-hospital, France. Patients: All patients younger than 18 years, admitted to the PICU, intubated and mechanically ventilated for more than 48 hours between January 2013 and December 2018, were included. Patients with aplasia or bacterial community-acquired pneumonia were excluded. VAP definition of the Centers for Disease Control and prevention was used. A survival analysis adjusted on duration of mechanical ventilation was used to study risk factors of VAP. Results: A total of 355 patients was included (median age 18 months and 62% were boys), 39 children (11%) developed a VAP and among them, 22 children (56%) had a bacteriological confirmation. The incidence rate of VAP was 15.5 per 1000 ventilation days. Nineteen VAP (49%) were considered as early onset. The main organism identified was Haemophilus influenzae (7/26). The age group 2-6 years was the most at risk of VAP (Hasard Ratio [HR] 2.66, 95% CI 1.26-5.62). Patients admitted for non-bacteriological respiratory disease were 76% (HR 0.24, 95% CI 0.05-0.99) less likely to have VAP before 15 days of ventilation. Conclusion: VAP are common in PICU. Risk factors identified in our study were non modifiable but the establishment of a prevention protocol may reduce this high rate.
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Master Thesis
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Submitted on : Monday, October 28, 2019 - 10:51:24 AM
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Emilien Maisonneuve. Évaluation de l’incidence des pneumopathies acquises sous ventilation mécanique en réanimation pédiatrique. Médecine humaine et pathologie. 2019. ⟨dumas-02335209⟩