Abstract
Background Ventilatory support is an essential therapy in Paediatric Critical Care Unit. Anticipating and managing extubation failure is a challenge and depends on clinical judgment, cardio respiratory, neurological and hemodynamic status of the patient.
Aim Analyzing the incidence, etiological factors & outcomes of extubation failure in paediatric intensive care unit.
Method Single centric, prospective, cohort study conducted in a PICU of tertiary care hospital in Mumbai over a period of 2 years. Children of 1 month to 12 years requiring mechanical ventilation and suffering Extubation failure during their stay in PICU were included. Using predesigned Performa, their demographic, Clinical and Biochemical parameters including ABG values were recorded and analyzed with appropriate statistical tests.
Result Total admissions in the PICU were 566, while 148 (25.14%) required mechanical ventilation and extubation failure was observed in 82 (55.41%) children. Most participants (58.5%) were 1 month to 1 year age, 56.1% were male, and 43.9% were female. Respiratory disease was the primary diagnosis for 61% of participants, while 28% had a deteriorating neurological condition, and 11% had cardiovascular disease. Extubation failure was most commonly due to inadequate gas exchange (43.9%), poor respiratory drive (41.5%), and neurological conditions (14.6%).
70.7% of participants expired, while 29.3% survived. There was no statistically significant correlation between the duration of ventilation, gender, reason for failure, biochemical parameters or co morbidities and the outcome.
A statistically significant correlation was found between MODS and the outcome.
Conclusion The extubation failure has significant morbidity and mortality, hence anticipation and proper planning is essential to prevent extubation failure and enhance outcomes.
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