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Gastroesophageal reflux in mechanically ventilated pediatric patients and its relation to ventilator-associated

Tarek A Abdel-Gawad1, Mostafa A El-Hodhod, Hanan M Ibrahim

  • 1Pediatric Department, Ain Shams Faculty of Medicine, Abbassia Ramsis St, Cairo 11566, Egypt. Gawad37@hotmail.com

Critical Care (London, England)
|October 21, 2009
PubMed

Insights

Gastroesophageal reflux (GER) is common in ventilated children and linked to ventilator-associated pneumonia (VAP). Acidic reflux predicts mortality in VAP patients, highlighting GER

Area of Science:

  • Pediatric Intensive Care
  • Gastroenterology
  • Critical Care Medicine

Background:

  • Gastroesophageal reflux (GER) is prevalent in pediatric patients requiring mechanical ventilation.
  • The association between GER and ventilator-associated pneumonia (VAP) in this population requires further investigation.
  • Understanding GER's role may improve VAP prevention and management strategies.

Purpose of the Study:

  • To determine the incidence of GER in mechanically ventilated pediatric patients.
  • To evaluate GER as a potential risk factor for VAP development.
  • To assess the impact of GER on VAP outcomes and mortality.

Main Methods:

  • Prospective cohort study in a pediatric intensive care unit.
  • Inclusion of 24 mechanically ventilated pediatric patients (16 with VAP, 8 without).
  • Utilized 24-hour esophageal pH-metry and clinical/laboratory assessments.

Main Results:

  • All VAP patients exhibited GER; 75% of non-VAP patients also had GER.
  • Mean total reflux time was significantly longer in VAP patients (50 min) vs. non-VAP (3 min).
  • Acidic reflux parameters were higher in non-survivors; total acidic reflux predicted mortality with 100% sensitivity and specificity.

Conclusions:

  • GER is a frequent occurrence in mechanically ventilated pediatric patients, with alkaline reflux being more common.
  • Both acidic and alkaline reflux are associated with VAP development.
  • Total reflux time is a reliable VAP predictor, and acidic reflux is more strongly linked to mortality.
Abstract

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