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Down syndrome and outcomes in critically ill pediatric patients

José Tantaleán Da Fieno1, Rosa León Paredes2, Patricia Palomo Luck3

  • 1Faculty of Human Medicine, Universidad Nacional Federico Villarreal, Lima, Peru.

Frontiers in Pediatrics
|February 10, 2025
PubMed

Insights

Children with Down syndrome (DS) admitted to the Pediatric Intensive Care Unit (PICU) face higher risks of healthcare-associated infections (HAIs) and prolonged mechanical ventilation. Underweight status in critically ill children also increases the likelihood of ventilation use and duration.

Area of Science:

  • Pediatric Intensive Care
  • Clinical Outcomes Research
  • Down Syndrome Research

Background:

  • Limited and conflicting data exist on children with Down syndrome (DS) in the Pediatric Intensive Care Unit (PICU).
  • Understanding clinical outcomes and nutritional status in this vulnerable population is crucial for improving care.

Purpose of the Study:

  • To investigate the association between Down syndrome (DS) and clinical outcomes in pediatric patients admitted to the PICU.
  • To assess the nutritional status of critically ill children with DS.

Main Methods:

  • Secondary analysis of a database from a tertiary care children's hospital in Lima, Peru.
  • Inclusion of 525 pediatric patients, collecting demographic, clinical, and nutritional data.
  • Application of Cox and Poisson regression analyses to determine the relationship between DS and outcomes like mortality, length of stay, mechanical ventilation duration, and healthcare-associated infections (HAIs).

Main Results:

  • Children with DS were younger, had more comorbidities, congenital heart disease, and underweight status.
  • DS was associated with higher mortality, increased HAIs, longer duration of mechanical ventilation (DMV), longer PICU stay, and fewer ventilator-free days (VFD).
  • Adjusted analyses showed significantly higher risk of HAIs (RR 2.95) and longer DMV (RR 1.43) in children with DS. Underweight was linked to increased MV use and longer DMV.

Conclusions:

  • Critically ill children with Down syndrome (DS) exhibit increased risks for healthcare-associated infections (HAIs) and prolonged mechanical ventilation (MV).
  • Underweight status in critically ill children is independently associated with a higher likelihood of MV use and extended duration of ventilation.
Abstract

Keywords:
Down syndromecohort studycritical careinfectionsmechanical ventilationpediatrics

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