关键词: 儿科重症监护室, 机械通气, 谵妄, 氧合指数

Abstract:

Objective To investigate the prevalence of delirium (PD) in children receiving mechanical ventilation (MV) treatment in the pediatric intensive care unit (PICU) and its related influencing factors. Methods The clinical data of children receiving MV treatment in the PICU from July 2022 to March 2023 were retrospectively analyzed. Results 149 children received MV, with a median age of 2.0(1.0-6.0) years, 74 males and 75 females. Among them, 86 children (57.7%) were aged ≤2 years, and 34 children (22.8%) were repeatedly intubated during treatment. Among 149 children, 81 (54.4%) had delirium. Compared with the non-delirium group, the delirium group was younger, had a lower proportion of prone position ventilation, a higher proportion of age ≤2 years, a longer PICU length of stay, and a higher proportion of PICU length of stay >14 days, with statistically significant differences (P<0.05). Compared with the non-delirium group, the delirium group had a higher proportion of oxygenation index ≤150mmHg on the first day of MV, a longer total MV time, and a lower proportion of total MV time ≤168 h, with statistically significant differences (P<0.05). Multivariate logistic regression analysis showed that PICU length of stay > 14 days and oxygenation index ≤ 150 mmHg on the first day of MV were independent risk factors for delirium in children with MV (P<0.05), while total MV time ≤ 168 h was a protective factor for delirium in children with MV (P<0.05). Conclusions The prevalence of delirium in children receiving MV treatment in PICU is higher, which is closely related to hypoxic injury. Long-term MV and PICU hospitalization are also important factors contributing to the development of delirium.

Key words: pediatric intensive care unit, mechanical ventilation, delirium, oxygenation index