Evidence map›Paper›PMID 40042159›Full record

ArticlePediatric pulmonology2025

Care Utilization for Acute Respiratory Infections in Children Requiring Invasive Long-Term Mechanical Ventilation.

Carolyn C Foster, Todd A Florin, Derek J Williams, Katherine L Freundlich, Rebecca L Steuart, Julia A Heneghan, Cara Cecil, Nathan M Pajor, Robert J Graham, Sriram Ramgopal

Abstract read
In one paragraph

Article in Pediatric pulmonology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Carolyn C FosterDivision of Advanced General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID http://orcid.org/0000-0001-6953-5968
Todd A FlorinStanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Derek J WilliamsDivision of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine and the Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Katherine L FreundlichDivision of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine and the Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Rebecca L SteuartDepartment of Pediatrics, Children's Hospital Wisconsin and Medical College of Wisconsin, Section of Complex Care, Milwaukee, Wisconsin, USA.ORCID http://orcid.org/0000-0002-5973-475X
Julia A HeneghanDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Cara CecilDepartments of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Nathan M PajorDivision of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID http://orcid.org/0000-0002-1637-4942
Robert J GrahamDivision of Critical Care Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0002-8659-6313
Sriram RamgopalStanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.

Funding

University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UM1TR004405 · NCATS · UNIVERSITY OF MINNESOTA · PI Bruce R Blazar, Damien A Fair · 2023 to 2026
$30.8M
CTSA K12 Program at University of MinnesotaK12TR004373 · NCATS · UNIVERSITY OF MINNESOTA · PI David H Ingbar · 2024 to 2026
$3.2M
HOMeVent4Kids: Home-based Optimization of Mechanical Ventilation for ChildrenK23HL149829 · NHLBI · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI FOSTER, CAROLYN C. · 2020 to 2024
$775k
Precision medicine approaches in the diagnosis of community-acquired pneumonia in childrenK01HL169921 · NHLBI · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI Sriram Ramgopal · 2024 to 2026
$504k
Dr. Foster is supported by the Yaeger Family Research Scholar Fund study and the National Heart, Lung, and Blood Institute (NHLBI) under 1K23HL149829-01A1. Dr. Ramgopal is supported by the NHLBI (K01HL169921).NCATS NIH HHS K12 TR004373NCATS NIH HHS UM1 TR004405NHLBI NIH HHS K01 HL169921NHLBI NIH HHS K23 HL149829
6 · The paper itself

Abstract

introductionChildren who use invasive long-term mechanical ventilation (LTMV) are a rare, clinically heterogenous population with relatively high hospitalization rates, most commonly for acute respiratory infection (ARI). We sought to describe patterns of ARI-related utilization and mortality in pediatric patients with LTMV, evaluating the association of a pre-existing neurologic diagnoses with outcomes.

methodsWe studied a longitudinal retrospective cohort across 40 U.S. children's hospital emergency department (ED) and hospital encounters for patients (< 21 years) with LTMV and an ARI diagnosis code (10/1/2016-6/30/2023). We examined mortality and ED/hospital utilization outcomes, defining short-stay hospitalizations as ≤ 2 calendar days. We stratified analyses by high intensity neurologic impairment (HINI) using a validated coding algorithm.

resultsWe included 4866 patients (median age 4.5 years; 58.6% male) with LTMV and ≥ 1 ARI encounter. Most (95.1%) were hospitalized on their index encounter, and among those most received intensive care (71.7%). 4.1% died during the index hospitalization (5.3% with HINI vs. 1.3% without HINI, p < 0.001). Median hospital length of stay was 6 days (interquartile range 3-12). Short stay hospitalizations occurred in 16.9% overall but were as high as 26.6% in children without HINI. ED return visits within 1 year occurred in 60.7%; ARI was the most common reason (40.1%).

conclusionsPediatric patients using LTMV presenting for ED care with ARI are almost always hospitalized, usually in an intensive care setting. Overall, outcomes were poorer for those with HINI than those without HINI. More precision is needed to align resources with illness severity and comorbidities to improve ARI outcomes.

Indexed as

HospitalizationRespiration, ArtificialRespiratory Tract InfectionsAcute DiseaseAdolescentChildChild, PreschoolEmergency Service, HospitalFemaleHumansInfantLength of StayLongitudinal StudiesMaleRetrospective StudiesUnited Statesacute respiratory infectionchildren with medical complexityhome mechanical ventilationlong‐term mechanical ventilationneurologic impairment

Identifiers

PMID40042159
PMCPMC11881213

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.