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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 1 of 1 Research Studies DisplayedLindell RB, Fitzgerald JC, Rowan CM
The use and duration of preintubation respiratory support is associated with increased mortality in immunocompromised children with acute respiratory failure.
The purpose of this retrospective cohort study was to examine the relationship between preintubation respiratory support and outcomes in pediatric patients with acute respiratory failure and to evaluate the impact of immunocompromised (IC) diagnoses on outcomes. The study utilized data from the Virtual Pediatric Systems database which included 82 centers, and focused on patients intubated in the Pediatric Intensive Care Unit (PICU) ranging in age from 1 month old to 17 years of age who received invasive mechanical ventilation (IMV) for more than or equal to 24 hours. Of the 5,348 PICU intubations across 82 centers, high-flow nasal cannula (HFNC) or noninvasive positive-pressure ventilation (NIPPV) or both were used before intubation in 34% (1,825) of patients. Fifty percent of the patients had no IC diagnosis. The researchers found that exposure to HFNC was associated with greater odds of PICU mortality when compared with patients intubated without prior support. When analyzing subgroups of IC status, preintubation support was related to higher odds of PICU mortality in IC patients and HCT patients when compared with IC/ HCT patients intubated without prior respiratory support. A duration of HFNC/NIPPV of more than 6 hours was associated with increased mortality in IC HCT patients. Rates of preintubation HFNC/NIPPV use and PICU mortality varied between the 82 centers. The researchers concluded that greater duration of exposure to HFNC/NIPPV prior to IMV is associated with increased mortality in HCT patients, and preintubation exposure to HFNC and/or NIPPV in IC pediatric patients is associated with increased odds of PICU mortality, independent of the severity of the illness.
AHRQ-funded; HS024511.
Citation: Lindell RB, Fitzgerald JC, Rowan CM .
The use and duration of preintubation respiratory support is associated with increased mortality in immunocompromised children with acute respiratory failure.
Crit Care Med 2022 Jul;50(7):1127-37. doi: 10.1097/ccm.0000000000005535..
Keywords: Children/Adolescents, Respiratory Conditions, Mortality, Critical Care