Objectives: To investigate the differences in clinical characteristics among children on prolonged mechanical ventilation (PMV) due to different primary diseases.
Methods: A retrospective analysis was performed on the clinical data of 59 pediatric patients requiring PMV from July 2017 to September 2022. According to the primary disease, they were divided into respiratory disease (RD) group, central nervous system (CNS) group, neuromuscular disease (NMD) group, and other disease group. The four groups were compared in terms of general information, treatment, and outcome.
Results: There were significant differences among the four groups in age, body weight, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score, Pediatric Risk of Mortality III (PRISM Ⅲ) score, analgesic and sedative treatment, nutrition supply, rehabilitation treatment, tracheotomy, successful ventilator weaning, and outcomes (P<0.05). Compared with the RD group, the CNS group and the other disease group had a significantly higher age and a significantly higher proportion of children receiving rehabilitation treatment, and the CNS group had a significantly higher proportion of children receiving tracheotomy (P<0.008). Compared with the other disease group, the CNS group and the NMD group had significantly lower PELOD-2 and PRISM III scores, and the CNS group had a significantly higher proportion of children with successful ventilator weaning and a significantly higher proportion of children who were improved and discharged (P<0.008).
Conclusions: There are differences in clinical characteristics among children receiving PMV due to different etiologies. Most children in the RD group have a younger age, and children in the CNS group have a relatively good prognosis.
目的: 探索不同原发病长期机械通气（prolonged mechanical ventilation, PMV）患儿临床特征的差异性。方法: 回顾性分析2017年7月—2022年9月59例PMV患儿的临床资料，按原发病分为呼吸系统疾病（respiratory disease, RD）组、中枢神经系统疾病（central nervous system, CNS）组、神经肌肉疾病（neuromuscular disease, NMD）组及其他疾病组，分析各组间一般资料、治疗和结局之间的差异。结果: 4组患儿在年龄、体重、儿童器官功能障碍评分-2、第三代小儿死亡风险评分、镇痛镇静治疗、营养供给、康复治疗、气管切开、撤机成功、出院结局方面比较差异有统计学意义（P<0.05）。两两比较显示，与RD组比，CNS组和其他疾病组年龄更大、接受康复治疗比例更高，CNS组气管切开比例更高（P<0.008）；与其他疾病组比，CNS组和NMD组儿童器官功能障碍评分-2、第三代小儿死亡风险评分更低，CNS组撤机成功、好转出院比例更高（P<0.008）。结论: 不同病因PMV患儿临床特点存在不同。RD组多为小年龄段患儿，CNS组患儿预后相对较好。.
Keywords: Child; Critical illness; Etiology; Prolonged mechanical ventilation.