ArticleBritish journal of anaesthesia2025
Neurodevelopmental and behavioural disorders after perioperative invasive mechanical ventilation in paediatric surgical admissions.
Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildren with a respiratory disease requiring invasive mechanical ventilation (IMV) in the paediatric intensive care unit (PICU) have an elevated risk for subsequent neurodevelopmental and behavioural disorders (NDBD). This study evaluates NDBD in children receiving IMV during surgical admissions.
methodsChildren enrolled in Texas Medicaid between 1999 and 2012 with a surgical admission were evaluated. Children in the PICU receiving IMV, in the PICU not receiving IMV, and in the intermediate medical care unit (IMCU) were identified and matched to children admitted to the general ward. The primary outcome was post-discharge NDBD. Secondary analyses evaluated NDBD risk by IMV duration and post-discharge psychotropic medication use.
resultsOf 35 161 children with surgical admissions meeting eligibility criteria, 993 were in the PICU with IMV, 7670 in the PICU without IMV, and 1027 in the IMCU. Increased rates of NDBD were observed in children receiving IMV (hazard ratio [HR] 1.91, 95% confidence interval [CI] 1.27-2.89, P=0.002), but not in those in the PICU without IMV (HR 1.12, 95% CI 0.98-1.29, P=0.10) or IMCU (HR 0.88, 95% CI 0.61-1.26, P=0.48). Elevated rates of NDBD were detected primarily in children receiving IMV for 96 h or more. Increased psychotropic medication use was observed only in the IMV group.
conclusionsChildren receiving invasive mechanical ventilation during a surgical admission are at increased risk of neurodevelopmental and behavioural disorders after hospital discharge. Further research is needed to clarify the mechanisms behind this association and to identify potentially modifiable risk factors.
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