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Steroid use is associated with pneumonia in pediatric chest trauma
M D Williams1, P E Reckard, R Knox
1Saint Joseph Hospital and Medical Center, Phoenix, Arizona.
Insights
Pediatric chest injuries in trauma patients can lead to pulmonary infections, increasing morbidity and hospital stay. Steroid use for brain injuries significantly elevates the risk of developing pneumonia in these children.
Area of Science:
- Pediatric Trauma Surgery
- Critical Care Medicine
- Pulmonary Medicine
Background:
- Pediatric chest injuries are a significant concern in trauma care.
- Understanding the complications of these injuries is crucial for improving outcomes.
Purpose of the Study:
- To review pediatric trauma cases with a focus on chest injuries.
- To identify factors associated with pulmonary infections in pediatric trauma patients.
Main Methods:
- Retrospective review of 342 pediatric trauma patients.
- Analysis of 80 patients with chest injuries, comparing infected vs. non-infected groups.
- Data collected included demographics, injury details, and treatment parameters.
Main Results:
- 23% of pediatric trauma patients had chest injuries; 20% of those developed pulmonary infections.
- Pneumonia was linked to longer hospital stays, intubation, and chest tube use.
- Steroid use for brain injury was a significant risk factor for pneumonia.
Conclusions:
- Pulmonary infections are a major complication of pediatric chest trauma.
- Steroid administration for concurrent brain injuries independently increases pneumonia risk.
- This highlights the need for careful management of steroid therapy in pediatric trauma patients with chest and brain injuries.
Abstract:
A review of pediatric trauma focused on pediatric chest injuries was performed at a trauma center specializing in neurologic trauma. Eighty of 342 (23%) pediatric trauma patients admitted to the center had chest injuries. Age, gender, mechanism of injury, magnitude of injury, incidence of pulmonary infection, chest tube usage, endotracheal intubation, steroid or antibiotic usage, morbidity, and mortality data were reviewed. Sixteen of 78 children (20%) with chest injuries developed pulmonary infections and were compared with the noninfected group. Patients with pneumonia had a higher morbidity with significantly longer mean hospital stay (43.0 vs. 12.7 days; p = 0.001), duration of intubation (8.4 vs. 1.5 days; p = 0.001), and total days with chest tubes, (2.2 vs. 1.4 days; p = 0.02). Pneumonia was significantly associated with longer mean duration of steroid usage (6.4 vs. 0.8 days; p = 0.0001). Duration of steroid administration for the treatment of concomitant brain injury was a significant independent risk factor for the occurrence of pneumonia.