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Clinical risk factors and a predictive nomogram for mechanical ventilation in pediatric patients with

Hongyan Peng1,2, Yiyu Yang1, Feiyan Chen1

  • 1Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.318 Renmin Middle Road, Yuexiu District, Guangzhou, 510120, China.

BMC Infectious Diseases
|December 9, 2025
PubMed

Insights

Younger age, high PaCO₂, and extensive lung involvement predict mechanical ventilation (MV) needs in children with plastic bronchitis (PB). A predictive model aids early risk assessment for better management.

Area of Science:

  • Pediatric Pulmonology
  • Critical Care Medicine
  • Respiratory Medicine

Background:

  • Plastic bronchitis (PB) in children can lead to respiratory failure requiring mechanical ventilation (MV).
  • Systematic risk assessments for MV in infection-related PB are currently lacking.
  • This study addresses the need for identifying risk factors and developing predictive tools.

Purpose of the Study:

  • To identify clinical risk factors for mechanical ventilation (MV) in pediatric patients with infection-related plastic bronchitis (PB).
  • To develop a predictive nomogram for individualized risk stratification in these patients.

Main Methods:

  • Retrospective cohort study of pediatric patients diagnosed with infection-related PB.
  • Univariate and multivariate logistic regression analyses to identify independent risk factors for MV.
  • Development and validation of a predictive model and nomogram using AUC and bootstrap resampling.

Main Results:

  • Younger age, elevated PaCO₂, and more extensive lobar involvement were identified as independent risk factors for MV.
  • A predictive model using age and PaCO₂ achieved an AUC of 0.922.
  • The nomogram demonstrated close agreement between predicted and observed outcomes.

Conclusions:

  • Age, PaCO₂, and lobar involvement are key predictors of MV in pediatric infection-related PB.
  • A predictive model based on age and PaCO₂ shows high discrimination and calibration.
  • The developed nomogram is a practical tool for early risk assessment and personalized management of PB.
Abstract

Keywords:
Mechanical ventilationPediatricPlastic bronchitisPredictive modelRisk factors

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