Meta-analysis of risk factors for ventilator-associated pneumonia in pediatric intensive care units

LIN Wei; ZHAO Fangmin; ZHAO Zhuying; ZHANG Jie

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Medical Journal of the Chinese People Armed Police Forces ›› 2024, Vol. 35 ›› Issue (10) : 838-843.

Meta-analysis of risk factors for ventilator-associated pneumonia in pediatric intensive care units

LIN Wei¹, ZHAO Fangmin¹, ZHAO Zhuying¹, ZHANG Jie²

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Abstract

Objective To systematically evaluate the risk factors for ventilator-associated pneumonia (VAP) in pediatric intensive care units (PICU). Methods Chinese and English databases such as CNKI, VIP, Wanfang, PubMed, Embase, The Cochrane Library, and CBM, were searched for literature on VAP risk factors in PICU. Meta-analysis was performed using RevMan5.4 and stata15.0. Results A total of 14 articles were included, including 9 in Chinese and 5 in English, involving 5,242 patients. Thirteen potential risk factors were comprehensively evaluated, and subgroup analysis were performed based on the study area. The results showed that age <1 year, respiratory disease, repeated intubation, parenteral nutrition, bronchoscopy, use of glucocorticoids, sedatives and acid suppressants were risk factors for VAP in PICU (P<0.05). Subgroup analysis indicated that these factors were statistically significant across different regions of China (P<0.05). Conclusions Medical staff should closely monitor the identified risk factors, utilize early detection strategies, and implement effective preventive measures to reduce the occurrence of VAP in PICU.

Key words

children / intensive care / ventilator-associated pneumonia / risk factors / meta-analysis

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LIN Wei, ZHAO Fangmin, ZHAO Zhuying, ZHANG Jie. Meta-analysis of risk factors for ventilator-associated pneumonia in pediatric intensive care units[J]. Medical Journal of the Chinese People Armed Police Forces. 2024, 35(10): 838-843

References

[1] Pena-Lopez Y, Pujol M, Campins M, et al. Assessing prediction accuracy for outcomes of ventilator-associated events and infections in critically ill children: a prospective cohort study[J]. Clin Microbiol Infect, 2018,24(7):732-737.
[2] 彭纯颖, 陆国平. 儿童呼吸机相关性肺炎的下呼吸道微生态研究进展[J]. 中国小儿急救医学, 2020,27(1):55-58.
[3] Morinec J, Iacaboni J, McNett M. Risk factors and interventions for ventilator-associated pneumonia in pediatric patients[J]. J Pediatr Nurs, 2012,27(5):435-442.
[4] Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol, 2010,25(9):603-605.
[5] 万有仓, 潘秀娟. PICU患儿发生呼吸机相关性肺炎的影响因素[J]. 临床肺科杂志, 2021,26(1):36-39, 44.
[6] 徐绍方. 儿童呼吸机相关性肺炎的临床研究[D].温州:温州医科大学, 2013.
[7] 周雄, 肖政辉, 贺杰, 等. 儿童重症病房呼吸机相关性肺炎临床危险因素分析[J]. 临床儿科杂志, 2018,36(5):352-355.
[8] 赵勍, 贺晓春, 何婧, 等. 儿童重症监护病房发生呼吸机相关性肺炎的危险因素分析[J]. 东南国防医药, 2022,24(4):377-381.
[9] 付秀梅, 张海先. 儿童重症监护室呼吸机相关性肺炎危险因素分析与干预措施[J]. 护理实践与研究, 2019,16(19).
[10] 丁盼盼. 探究儿童重症监护室呼吸机相关肺炎影响因素及护理干预措施[J]. 黑龙江中医药, 2020,49(5):150-151.
[11] 刘丹丹. 小儿呼吸机相关性肺炎病原学及危险因素分析[D]. 华北理工大学, 2015.
[12] 张丽. 小儿重症监护病房中呼吸机相关性肺炎危险因素及康复护理[J]. 辽宁中医药大学学报, 2019,21(3):217-220.
[13] 张爱珍. 儿童重症监护室呼吸机相关肺炎影响因素及其护理对策探讨[J]. 系统医学, 2019,4(14):190-192.
[14] Chen R, Liu Y, Zhang X, et al. Risk factors and nursing countermeasures of ventilator-associated pneumonia in children in the intensive care unit[J]. J Healthc Eng, 2022,2022:9055587.
[15] Amanati A, Karimi A, Fahimzad A, et al. Incidence of ventilator-associated pneumonia in critically ill children undergoing mechanical ventilation in pediatric intensive care unit[J]. Children (Basel), 2017,4(7).
[16] Kusahara D M, Enz C C, Avelar A F, et al. Risk factors for ventilator-associated pneumonia in infants and children: a cross-sectional cohort study[J]. Am J Crit Care, 2014,23(6):469-476.
[17] Chomton M, Brossier D, Sauthier M, et al. Ventilator-associated pneumonia and events in pediatric intensive care: a single center study[J]. Pediatr Crit Care Med, 2018,19(12):1106-1113.
[18] Gupta S, Boville B M, Blanton R, et al. A multicentered prospective analysis of diagnosis, risk factors, and outcomes associated with pediatric ventilator-associated pneumonia[J]. Pediatr Crit Care Med, 2015, 16(3):e65-e73.
[19] Wu L, Liu B. The clinical effect of a bronchofiberscope in treating severe ventilator-associated pneumonia[J]. Am J Transl Res, 2021,13(6):6966-6972.
[20] 徐纯, 赵丽, 周晓红, 等. PICU机械通气患儿并发呼吸机相关性肺炎风险预测模型的构建及效果检验[J]. 临床护理杂志, 2023,22(3):38-43.
[21] 中华医学会呼吸病学分会感染学组. 《中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)》[J]. 中华结核和呼吸杂志, 2018,4(41):255-280.
[22] 丁璐, 吴本清. 早产儿支气管肺发育不良的病因及发病机制新进展[J]. 国际儿科学杂志, 2008,6(35):580-582.
[23] 赵丽琼, 赵红琼, 李雪梅, 等. 留置不同人工气道长期机械通气患者原因、并发症及预后的探讨[J]. 中国医药导报, 2017,14(7):53-56.
[24] Eulmesekian P G. Risk Factors for preventing ventilator-associated events in children: have we recognized them yet?[J]. Pediatr Crit Care Med, 2018,19(1):83-84.
[25] 刘燕, 王磊, 葛燕萍, 等. 呼吸内科重症监护病房慢性阻塞性肺疾病机械通气患者肠内外营养的疗效比较[J]. 临床荟萃, 2012,27(14):1239-1240.
[26] De Deyne C, De Jongh R, Merckx L, et al.Early enteral feeding in cranial trauma[J]. Ann Fr Anesth Reanim, 1998,17(2):192-194.
[27] 杨玉琪, 周磊, 贺文芳, 等. MLST方法用于支气管镜检查治疗室院内感染调查研究[J]. 检验医学与临床, 2022,19(13):1733-1736.
[28] 宋洁, 周雅琼. 重症肺炎患儿行纤维支气管镜术后并发症预防措施的研究进展[J]. 当代护士(下旬刊), 2021,28(4):31-34.
[29] 姚培宇,丁钋, 张茁. 肠内外联合营养对机械通气患者预后影响的Meta分析[J]. 继续医学教育, 2017,31(1):139-141.
[30] 和铭洁. 机械通气患者呼吸机相关性肺炎的危险因素和预后措施研究[J]. 黑龙江医学, 2022,46(2):207-209.
[31] 申沪, 吴洪波, 曹煜. 老年慢性阻塞性肺疾病急性加重期患者并发肺部真菌感染的相关因素[J]. 中国老年学杂志, 2023,43(19):4687-4690.
[32] 范晓航, 刘丽琴. ICU患者呼吸机相关性肺炎的影响因素及护理措施[J]. 护理学, 2023,3(12):245-251.
[33] 尤婷, 胡莉, 米元元, 等. 呼吸机相关性肺炎预防的最佳证据总结[J]. 护理学, 2023,1(12):35-46.