Endotracheal tube repositioning and its association with ventilator-associated pneumonia in pediatric intensive care unit: a hospital-based cross-sectional study
Abstract
Abstract Background: Ventilator-associated pneumonia (VAP) is one of the most common hospital-acquired infections. The existing literature has revealed several risk factors for the development of VAP, but only a few studies show an association between endotracheal tube (ETT) repositioning and a risk of VAP. Objective: The Primary objective was to evaluate repositioning of ETT as a risk factor for ventilator-associated pneumonia in children admitted for more than 48 hours for non-pulmonary indications in the pediatric intensive care unit (PICU). The secondary objective was to assess the role of reintubation as a risk factor for VAP in the same cohort. Design: Hospital-based cross-sectional study. Setting: Tertiary care facility equipped with pediatric intensive care. Participants: Children aged less than 15 years. Results: Repositioning of ETT was done in 11 patients, of whom 8 had VAP. Patients with ETT repositioning had twice the odds of developing VAP, although this was not statistically significant (OR = 2.22; P = .2). Reintubation was done in 27 patients, out of which 22 (57.9%) had VAP (P < .001), and it increased the risk of VAP by 6.3 times (OR = 6.3; P < .001). Multivariate regression analysis revealed that reintubation was the only independent risk factor for the development of VAP. Conclusion and relevance: Although our analysis did not find ETT repositioning to be an independent risk factor, the observed results indicate that it would be beneficial to look further…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 27 participants or records.
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