The Incidence of Ventilator‐Associated Pneumonia in a Tertiary Paediatric Intensive Care Unit—A Retrospective Cohort Study

ABSTRACT

Aim
The aims of this study were to estimate the incidence of ventilator‐associated pneumonia (VAP), explore the patient and clinical factors associated with the diagnosis of VAP, and establish the outcomes of children with VAP in our paediatric intensive care unit (PICU).


Methods
This study was conducted in the PICU at the Women's and Children's Hospital, South Australia. Demographic and clinical data were collected from paper‐based and electronic medical records for children aged under 18 years who were mechanically ventilated for ≥ 48 h in the PICU between 2019 and 2023.


Results

Two hundred and twenty patients were included in the analysis. Twenty‐eight patients were clinically diagnosed with VAP, with an incidence of 12.7% and an incidence density of 13.7 per 1000 ventilator days. Patients with clinician‐diagnosed VAP were mechanically ventilated for longer than those without VAP (median hours 298.50 compared to 119.50,
p
 = < 0.001). The median hospital length of stay (LOS) was longer by 17 days (95% CI: 2.97–31.03,
p
 = 0.018) and the median ICU LOS was longer by 14 days (95% CI: 9.64–18.36,
p
 = < 0.001) in patients with clinician‐diagnosed VAP. The use of vasoactive medications was significantly higher in those with clinician‐diagnosed VAP as compared to those without (RR 2.37; 95% CI: 1.09–5.14,
p
 = 0.030).



Conclusions
The incidence of VAP in our PICU was 12.7%. Clinician‐diagnosed VAP was associated with longer duration of mechanical ventilation, longer hospital and ICU LOS, and increased use of vasoactive medications.