Does Re-intubation Increased Risk of Ventilator-Associated Pneumonia (VAP) in Pediatric Intensive Care Unit Patients?

Abstract

Introduction Ventilator-Associated Pneumonia (VAP), as defined by the Centers for Disease Control and prevention (CDC), is a pneumonia that occurs in a patient receiving mechanical ventilation that develops 48 hours or more after initiation of ventilation. Re-intubation which occur within 72 hours of planned extubation may be effective in VAP incidence. The aim of this study was to determine VAP incidence in re-intubated patients in comparison to patients underwent intubation without re-intubation to highlight re-intubation as a risk factor for VAP. Methods and Materials A total of 1230 intubated patients, admitted to Pediatric Intensive Care Unit (PICU) department were enrolled in this cohort observational study consecutively from May 2010 to May 2014. VAP was clinically suggested and confirmed by chest X-ray. Patients demographic data, underlying disease, duration of mechanical ventilation length of PICU stay and re-intubations were recorded prospectively. Results In this study 336 intubated patients out of 1230 patients admitted to PICU department developed VAP (27%) with higher incidence in re-intubated patients (30% vs. 12%). Conclusion VAP developed in nearly one third of intubated patients in our study. Re-intubation was significant risk factor for development of VAP.