Fouzia Shaukat, Sajid Maqbool, Sadaf Ali Jaffari, Akbar Malik.
Mechanical Ventilation in Children - A Challenge.
Proceeding Shaikh Zayed Postgrad Med Inst Jan ;14(1):44-52.

Mechanical ventilation is a life saving adjunct to the treatment of critically ill children. In order to assess the usefulness of mechanical ventilation amongst our sick children, this study was carried out at the Paediatric Intensive Care Unit at Shaikh Zayed Hospital, Lahore. A total of 464 paediatric patients were included in the study. The study was carried out for a period of 6 years (1st January 1994 to 30th December 1999). The overall percentage of paediatric admissions to ICU requiring mechanical ventilation in our study was 23.5%. 68% of the patients who required MV were under one year of age, with median age of 26 months. Males out-numbered females with male to female ratio of 2:1.5. A majority (66.8%) of patients who required MV were received in PICU in critically ill condition. The average duration of endoctracheal intubation and mechanical ventilation in our study was 6 days while the average duration of stay in PICU was 9 days. The need for MV in our study was indicated by hypoxia (10%), hypercarbia (46%) frequent apnoea (19%) and/or respiratory arrest (26%). Amongst the major indications for MV in our setup were central nervous system (CNS) conditions (29.3%) infectious diseases (26.2%) and respiratory conditions (22.6%). Maximum survival was documented for CNS conditions (46.3%), while 43% patients belonging to the respiratory and gastrointestinal diseases survived. Highest mortality was documented with haematology/oncology (91.6%), infectious diseases (88%) and cardiovascular diseases (81.2%). Our study reveals an overall high mortality rate of 63% associated with mechanically ventilated children but the important finding was that out of the critically sick children admitted to PICU 37% could be saved because mechanical ventilation provided tune and support to these children for their specific treatment to prove effective.

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