Amany Mohammed El-Rebigi, Amany Nagah Fekry1, Maha A. Elfaramawy, Rasha Mohammed Zakaria

Department of Pediatric and Neonatology, Faculty of Medicine, Benha University, Benha, Egypt
1Department of Anesthesia and Surgical ICU, Faculty of Medicine, Benha University, Benha, Egypt

Keywords: Children, comorbidities, complications, mechanical ventilation, pediatric intensive care unit

Abstract

OBJECTIVES: Mechanical ventilation (MV) is frequently employed in acute care settings for severely ill children, but it may be associated with adverse events (AEs). This study investigated the AEs and comorbidities in children receiving invasive MV (IMV).

METHODS: This retrospective cross sectional study assessed pediatric patients admitted to the pediatric intensive care unit from January 2021 to December 2023 and received IMV. Demographics, clinical findings, concurrent medical conditions, ventilator settings, complications, and outcomes were collected. The predictors of MV related AEs were assessed using multivariate logistic regression.

RESULTS: One quarter (24.1%) of the patients experienced at least one AE. Ventilator associated pneumonia (VAP) was the most common consequence (13%), followed by postextubation stridor (7.9%) and air leak syndrome (pneumothorax) (6%). Only 12.4% of cases had comorbidities and the death rate was 9.8%. The factors significantly associated with AEs included nonrespiratory causes for admission, prolonged MV duration, and the presence of comorbidities.

CONCLUSIONS: There is an elevated incidence of AEs, with VAP being the most frequent. Nonrespiratory causes for admission, prolonged MV, and preexisting comorbidities were the main predictors of AEs.

How to cite this article: El-Rebigi AM, Fekry AN, Elfaramawy MA, Zakaria RM. Mechanical ventilation-associated complications and comorbidities in children admitted at pediatric intensive care unit: A cross-sectional retrospective study. Turk J Emerg Med 2025;25:230-8.

Ethics Committee Approval

The study was reviewed and approved by the Ethics Committee at the Faculty of Medicine, Benha University (Approval no.: RC# 16‑4‑2023, Approval Date: April 16, 2023). Also, the analysis was registered on ClinicalTrials.gov (NCT# 06368973).

Author Contributions

• AME: Conceptualization (lead); Writing – original draft (lead); Writing – review and editing (equal)
• ANF: Data collection(lead); Formal analysis (lead); Writing – review and editing (equal)
• MAE: Methodology (lead); Data collection (supporting); Writing – review and editing (equal)
• RMZ: Data collection (supporting); Formal analysis (supporting); Writing – review and editing (equal).

Conflict of Interest

None Declared.

Financial Disclosure

None.

Acknowledgments

We would like to express our heartfelt gratitude to the PICU, Faculty of Medicine, Benha University, for their invaluable support and provision of the necessary facilities to conduct this study. We also extend our sincere appreciation to the medical and technical staff for their unwavering dedication and assistance throughout the research process.