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ABSTRACT 659: VENTILATOR ASSOCIATED PNEUMONIA IN PAEDIATRIC INTENSIVE CARE INCIDENCE & OUTCOME IN SOUTH EAST SCOTLAND

Chinchankar, N.1; Milnes, R.2; Lo, T.Y.M.1

Pediatric Critical Care Medicine: May 2014 - Volume 15 - Issue 4_suppl - p 149
doi: 10.1097/01.pcc.0000449385.49074.b2
Abstracts of the 7th World Congress on Pediatric Critical Care
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1Paediatric Intensive Care Medicine, Royal Hospital for Sick Children, Edinburgh, United Kingdom 2Child Life and Health, University of Edinburgh, Edinburgh, United Kingdom

Background and aims: Ventilator associated pneumonia (VAP) is a serious hospital acquired infection that prolongs intensive care unit (ICU) stay and increases mortality in adults. VAP is common affecting upto 50% of adult ventilated patients but the lack of unified paediatric definition of VAP, it is difficult to estimate its impact in paediatric practice.

Aims: Our study aims to define a clinically useful definition of VAP using information from the existing literature; then employ this definition to a cohort of paediatric intensive care patients to determine the incidence of paediatric VAP and its relationship to outcome.

Methods: A clinically useful definition of paediatric VAP was defined using a literature search of the existing definitions of VAP in both adults and children. Then through a retrospective case note review and applying this pre-defined definition, the incidence of paediatric VAP in a single PICU within Scotland was determined. IRB waived the need for informed consent.

Results: 51 of the 202 ventilated paediatric patients (April 2012 - March 2013) had VAP giving a rate of 25.2%. VAP was associated with a significantly longer duration of ventilation (p < 0.01), a delayed PICU discharge (p < 0.01), but no impact on mortality (p = NS). Our clinical definition had a sensitivity and specificity of 78.4% and 100% respectively for diagnosing VAP.

Conclusions: VAP affects 25.2% of ventilated paediatric patients and delays PICU discharge. Further investigations into the prevention of this common hospital acquired infection are warranted.

©2014The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies