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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Daily practice of mechanical ventilation in Italian pediatric intensive care units: A prospective survey
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Daily practice of mechanical ventilation in Italian pediatric intensive care units: A prospective survey

机译：意大利儿科重症监护室机械通气的日常实践：一项前瞻性调查

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Objectives: To assess how children requiring endotracheal intubation are mechanically ventilated in Italian pediatric intensive care units (PICUs).Design: A prospective, national, observational, multicenter, 6-month study.Setting: Eighteen medical-surgical PICUs.Patients: A total of 1943 consecutive children, aged 0-16 yrs, admitted between November 1, 2006 and April 30, 2007.Interventions: None.Measurements and Main Results: Data on cause of respiratory failure, length of mechanical ventilation (UN), mode of ventilation, use of specific interventions were recorded for all children requiring endotracheal intubation for >24 hrs. Children were stratified for age, type of patient, and cause of respiratory failure. A total of 956 (49.2%) patients required MV via an endotracheal tube; 673 (34.6%) were ventilated for >24 hrs. The median length of MV was 4.5 days for all patients. If postoperative patients were excluded, the median time was 5 days. Bronchiolitis (6.7%), pneumonia (6.7%), and upper airway obstruction (5.3%) were the most frequent causes of acuterespiratory failure, and altered mental status (9.2%) was the most frequent reason for MV. The overall mortality was 6.7% with highest rates for heart disease (nonoperative), sepsis, and acute respiratory distress syndrome (26.1%, 22.2%, and 16.7% respectively). Length of stay, associated chronic disease, severity score on admission, and PICU mortality were significantly higher in children who received MV (p < .05) than in children who did not. Controlled MV and pressure support ventilation + synchronized intermittent mandatory ventilation were the most frequently used modes of ventilatory assistance during PICU stay.Conclusions: Mechanical ventilation is frequently used in Italian PICUs with almost one child of two requiring endotracheal intubation. Children treated with MV represent a more severe category of patients than children who are breathing spontaneously. Describing the standard care and how MV is perfor...
机译：目的：评估需要在意大利小儿重症监护病房（PICU）中进行气管插管的儿童的机械通气设计：一项前瞻性，全国性，观察性，多中心，为期6个月的研究背景：18例外科外科PICU患者：总计于2006年11月1日至2007年4月30日期间收治的1943名年龄在0-16岁之间的连续儿童。干预措施：无。测量和主要结果：呼吸衰竭原因，机械通气时间（UN），通气方式的数据记录了所有需要气管插管> 24小时的儿童的具体干预措施。根据年龄，患者类型和呼吸衰竭原因对儿童进行分层。共有956名（49.2％）患者需要通过气管导管进行MV。 673（34.6％）通风> 24小时。所有患者的MV中位数为4.5天。如果排除术后患者，中位时间为5天。毛细支气管炎（6.7％），肺炎（6.7％）和上呼吸道阻塞（5.3％）是急性呼吸衰竭的最常见原因，精神状态改变（9.2％）是MV的最常见原因。总体死亡率为6.7％，其中心脏病（非手术），败血症和急性呼吸窘迫综合征的发生率最高（分别为26.1％，22.2％和16.7％）。 MV患儿的住院时间，相关的慢性病，​​入院时的严重程度评分以及PICU死亡率均显着高于未接受MV患儿（p <.05）。 MV和压力支持通气+同步间歇性强制通气是PICU住院期间最常用的通气辅助方式。结论：意大利PICU中经常使用机械通气，几乎有两个孩子需要气管插管。与自发呼吸的儿童相比，接受MV治疗的儿童所代表的患者类别更为严重。描述标准护理以及MV的表现...

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