A constellation of adverse effects and complications may be associated with mechanical ventilation,The following are the Commonest Complications of Mechanical Ventilation~Ventilator-associated pneumonia.~Ventilator-induced lung injury.~Ventilation induce Hemodynamic compromise leads to ARDS. Ventilator-Associated Pneumonia (VAP) It refers to nosocomial pneumonia occurring 48 hours or more after initiation of mechanical ventilation (MV)~It is the second most common HAI after blood stream infection in the paediatric age group, accounting for about 20% of all HAIs in the paediatric intensive care units (PICUs) and has a rate of 2.9- 21.6 per 1000 ventilator days.The risk factors responsible for VAP occurrence can be classified into:~A-Host related factors: include associated co-morbidities B-Device-related factors: include the endotracheal tube, the ventilation circuit, and the presence of a nasogastric or an orogastric tube.~C-Personnel related factors: include improper hand hygiene and inadequate use of personal protective equipment.~VAP is associated with increased hospital morbidity; mortality; duration of hospitalization by an average of 7-9 days per patient; and health care costs . The incidence rates of VAP are higher in developing countries with limited resources.~Ventilator-associated lung injury (VALI) It is the lung damage by application positive or negative pressure to the lung by mechanical ventilation.~The prevalence of VALI in children admitted to the paediatric intensive care unit (PICU) may approximate 10%.~Types of VALI:~Voltrauma (This is damage caused by over-distension)~Barotrauma (destructive entry of pressurised airway gases into the parenchyma, or into blood vessels.)~Biotrauma (is known to upregulate pulmonary cytokine production)~Oxygen toxicity (This is the damage caused by a high concentration of inspired oxygen)~Recruitment /de-recruitment injury (atelectotrauma)~Shearing injury Risk factors for VALI: blood product transfusion, acidaemia, and history of restrictive lung disease. larger tidal volume.~investigators observed lower mortality among children ventilated with Vt ~8 mL/kg actual bodyweight compared with ~10 mL/kg in a before-after retrospective study .~Ventilation induce Hemodynamic compromise leads to ARDS:~Definition: Decrease in mean arterial pressure of 60 mm Hg or an absolute decrease to a systolic blood pressure < 80 mm Hg in the first 2 hours after intubation, required treatment for LTH with vasopressors.~primary factor influencing mortality in acute respiratory distress syndrome (ARDS) Incidence: 28.6% of patients intubated in the emergency department developed post-intubation hypotension, tatistically significant association between LTH and hyper carbic (PCO2 > 50 mm) chronic obstructive pulmonary disease
This study aims to determine the incidence, risk factors and outcome of ventilation associated common complication in the PICUs at Assiut University Children Hospital in Egypt.