Endotracheal Tube-Associated Complications in Paediatric Critical Care: A Systematic Review and Meta-Analysis.
Joanne Curlis, Karina R Charles, Ruth Royle and 4 others
PMID 40522230WHAT IT FOUND
Critically ill children with endotracheal tubes developed ventilator-associated pneumonia at 13.5 per 1000 ventilator days, accidental extubation at 7.4 per 1000 days, and tube blockage at 5.0 per 1000 days.
Rates varied widely.
Key findings
01The review included 34 studies involving 50 359 patients, and pooled VAP incidence was 13.5 per 1000 ventilator days (95% CI 8.2 to 22.2).
02Accidental extubation occurred at 7.4 per 1000 ventilator days, ETT blockage at 5.0 per 1000 ventilator days, and pressure injury at 5.4 per 1000 ventilator days.
03Subgroup analyses reported VAP rates of 7.7 versus 14.5 per 1000 ventilator days by tube dwell time and 20.7 versus 7.8 per 1000 ventilator days by country economic status, with wide confidence intervals.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Different studies used different definitions for ventilator-associated pneumonia and related infections, so pooled rates may not be comparable. The main pooled estimate had very high heterogeneity, and subgroup differences had wide overlapping confidence intervals. Many included studies were single-site, and some were retrospective or had small samples. The review did not test whether any intervention reduced complications; it only reported incidence. Older studies and non-English studies were excluded. Some outcomes, such as cuff dysfunction, tube kinking, and airway injury, were underreported.
The easy way to misread this
Do not read the pooled rates as a precise estimate for every unit. Definitions varied widely, heterogeneity was high, and subgroup differences had wide overlapping confidence intervals. The review did not test whether any intervention reduced complications.