Risk factors for extubation failure in mechanically ventilated children in pediatric intensive care unit

  • Supreet Khurana
  • Siddharth Bhargava
  • Puneet A Pooni
  • Deepak Bhat
  • Gurdeep Dhooria
  • Jatinder Goraya
  • Kamaldeep Arora
  • Shruti Kakkar

Abstract

Background: Mechanical ventilation is lifesaving in children with respiratory failure. However, its unnecessary prolongation once a child is capable of sustaining spontaneous effective ventilation is associated with significant complications. Objective: To identify the factors that lead to higher chance of extubation failure in mechanically ventilated children. Materials and Methods: A prospective, observational study was conducted over a period of 1 year. Children admitted to pediatric intensive care unit of a tertiary care hospital of Northern India aged 1 month–17 years, needing mechanical ventilation were included in the study. Predefined criteria were used to decide the timing of extubation. Relevant details were recorded to study various patient-related parameters and their association with extubation outcome. Results: Mean age of the study group was 50 months with a male:female ratio of 3:1. Extubation failure rate was 14.5%. Extubation failure was significantly higher in patients ventilated for >7 days (p=0.01), those with the pediatric risk of mortality score >10 at admission (p=0.009), in addition to peak inspiratory pressure >16 cm H2O (p=0.009) and FiO2 ≥0.35 (p=0.01) before extubation. Accidental extubation was also associated with higher extubation failure (p<0.001). Conclusion: Our study demonstrates that even though sicker patients requiring ventilation for longer duration are more prone to failed extubations, protocol based, and planned extubations lead to better extubation success.

Keywords: Accidental extubation, Duration of ventilation, Fraction of inspired oxygen, Peak inspiratory pressure, Pediatric risk of mortality score
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How to Cite
Khurana, S., Bhargava, S., Pooni, P. A., Bhat, D., Dhooria, G., Goraya, J., Arora, K., & Kakkar, S. (2019). Risk factors for extubation failure in mechanically ventilated children in pediatric intensive care unit. Indian Journal of Child Health, 6(7), 379-382. https://doi.org/https://doi.org/10.32677/IJCH.2019.v06.i07.012
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Original Articles