SynthesisNursing in critical care2025
Endotracheal Tube-Associated Complications in Paediatric Critical Care: A Systematic Review and Meta-Analysis.
Synthesis in Nursing in critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
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Who cites it
2 citing papers in PubMed.
- Incidence, Mortality, and Determinants of Ventilator-Associated Pneumonia Among Pediatric Patients at the National Referral Hospital, Bhutan: A Prospective Cohort Study.Health science reports · 2026Article
- Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChildren admitted to the paediatric intensive care unit who require mechanical ventilation are at increased risk for endotracheal tube complications. Increased endotracheal tubes complications can lead to increased length of stay and subsequent increased health care costs.
aimTo estimate the incidence of endotracheal tube-associated infections and other complications in mechanically ventilated children. STUDY
designSystematic review and meta-analysis of observational studies. The electronic databases and search machines PubMed, Embase and Cumulative Index of Nursing and Allied Health Literature (CINAHL) were searched for articles published 2012 to 2023. We included cohort studies and randomized controlled trials set in paediatric intensive care that reported endotracheal tube-associated complications (infection, accidental removal, pressure injuries and blockage). Study eligibility assessment, data extraction and critical appraisal were undertaken by pairs of reviewers. Pooled estimates of complications were generated using random effects meta-analysis. Study quality was assessed using the Critical Appraisal Skills Programme tool for randomized controlled trials and cohort studies.
resultsWe included data from 34 studies (12 RCTs and 22 cohort studies; n = 50 359 patients; 232 123 ventilator days). There was substantial study heterogeneity. The primary outcome was endotracheal tube-associated infection: ventilator-associated pneumonia, ventilator-associated events and/or ventilator-associated tracheobronchitis. Ventilator-associated pneumonia was the most common endotracheal tube-associated complication (incidence rate 13.5/1000 ventilator days; 95% confidence interval [CI] 8.2, 22.2) with higher rates in low- and middle-income countries than high-income economies (incidence rate difference 11.9%; 95% CI 10.2, 13.7). Accidental extubation was the second most common complication (7.4/1000 ventilator days; 95% CI 5.1, 10.7) followed by endotracheal tube-associated pressure injuries (5.4/1000 ventilator days; 95% CI 1.7, 16.6) and endotracheal tube blockage (5.0/1000 ventilator days; 95% CI 1.4, 17.6).
conclusionsEndotracheal tube-associated complications remain prevalent and contribute avoidable harm. The continued high incidence of ventilator-associated pneumonia highlights further efforts are needed to reduce burden, especially in lower- and middle- income countries. RELEVANCE TO CLINICAL PRACTICE: Awareness of endotracheal tube-associated complications will promote initiatives to reduce complications and prevent patient harm. Prospero Registration: PROSPERO 2022 CRD42022339900.
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