A Retrospective Study on the Prevalence and Factors Associated With Prolonged Endotrachealintubation (ETI) in the Pediatric Population at the Georgetown Public Hospital Corporation (GPHC) From January 1, 2021 to December 31, 2021
Introduction
Background/Introduction: Many sources note that prolonged intubation can result in complicationssuch as tracheal stenosis, vocal cord paralysis, and risk for cardiac arrest.Therefore, knowledge of its contributing factors would benefit medicalpractitioners in strategizing care for critical patients.
Objectives
Objective: To calculate the prevalence of, and highlight the most common factorsassociated with prolonged intubation.
Method
Method: Retrospective study with all inclusive sampling (ConfidenceInterval: 100%) of patients who were intubated for ≥ 7 days while admittedto the PHDU/ICU, GPHC, during 2021.
Results
Results: 11 patients met the inclusion criteria; 54.5% were male, 45.5% of mixed-race, and 63.6% between ages 3-12 years old. The prevalence of prolongedintubation was 31.4%, with 82% intubated for 7-9 days. Neurologicaldisorders (36%), and infectious diseases (45%) were the predominantdiagnoses. 64% had negative culture results, while 91% used antimicrobialtherapy. All children who had an Arterial Blood Gas (ABG) done, wereacidotic. 64% required inotropic support, and blood transfusions. 55%required single resuscitation, but did not require re-intubation. 72% weremanaged by >2 teams, and 55% had an invasive procedure(s). Severalcomplications resulted from prolonged intubation.
Conclusion
Conclusion: The prevalence of prolonged intubation within the study population was notsignificantly high. Though majority of the study findings were not statisticallysignificant, due to an inherently small population, the use of antimicrobialtherapy, inotropic support, blood transfusions, ABG monitoring, lesser/noinvasive procedures, and more MDT decision making, are all possible factorsto prevent prolonged intubation.
Recommendations
Recommendation(s): A larger sample size and study period would aid statistical relevance.