Retrospective cohort study identifies risk factors for VAP in pediatric severe TBI, suggesting clinical implications.
Key Points
The study aims to identify risk factors for ventilator-associated pneumonia (VAP) in pediatric patients with severe traumatic brain injury (TBI).
Conducted a retrospective cohort study at a single academic institution.
Included patients under 18 years old with severe TBI intubated for more than 48 hours between 2020 and 2024.
Collected data on demographics, injury characteristics, and TBI therapies.
Performed univariable analysis then multivariable survival analysis to find significant predictors of time to VAP diagnosis.
Out of 75 patients, 30 developed VAP and 45 remained free of VAP during hospitalization.
Increased risk factors for VAP included male gender (HR=3.34, p=0.011), aspiration during intubation (HR=7.85, p<0.001), and enteral feeds (HR=2.95, p=0.02).
Treatment with albuterol was protective against VAP (HR=0.67, p=0.001).
VAP diagnosis was linked to a longer hospital stay (HR=1.02, p=0.004).
No significant difference was found in VAP risk based on enteral feeding site (distal to pylorus or stomach).