Characterization of pediatric patients with severe community-acquired acute respiratory infections requiring invasive mechanical ventilation

Abstract

Severe acute respiratory infections (SARI) are a leading cause of morbidity and mortality in pediatrics, with high rates of outpatient visits, hospitalizations, and admissions to the Intensive Care Unit (ICU).

Objective: To describe the clinical and demographic characteristics of pediatric patients with community-acquired acute respiratory infections (CA-ARI) requiring invasive mechanical ventilation (IMV).

Patients and Method: Retrospective, observational study of patients under 15 years of age admitted to the ICU with a diagnosis of CA-ARI who required IMV between 2019 and 2022 at the Hospital Dr. Exequiel González Cortes. Results: Overall, 202 patients were analyzed with a median age of 4 months; sex: 63% male. Comorbidity: 47%; median hospital stays: 14 days; ICU stay: 8 days; median MV: 5 days. Identification of virus only (68%), virus and bacteria (18%), bacteria only (3%), and no agent identified (11%). Microbiological identification was successful in 89% of cases. The most prevalent virus was Respiratory Syncytial Virus (RSV) (67%), and Moraxella catarrhalis was the most common bacterium (29%). RSV was associated with longer IMV time. Healthcare-associated infections: 10%; complications: 40%. Indexed mortality was 1.07.

Conclusions: Most cases of ARI requiring IMV occurred in infants under 6 months of age and were associated with longer hospital stays and higher complication rates. RSV was the main etiological agent, and there were low bacterial detection rates. It is important to develop strategies to optimize the clinical management of these patients.