Prevention of immunoglobulin on ventilator-associated pneumonia in critically ill children:a retrospective study.

BACKGROUND

Ventilator-associated pneumonia (VAP), a leading ICU-acquired infection, prolongs ICU stays, increases costs, and elevates mortality. The impact of intravenous immunoglobulin (IVIG) on VAP incidence in children remains unclear.

METHODS

We enrolled 228 PICU patients undergoing mechanical ventilation (≥48 h) from June 2019 to June 2023. Seventy-five of them developed VAP (VAP group), while the remaining 153 children constituted the non-VAP group. We analyzed the relationship between IVIG administration within 30 days prior to ventilation and the occurrence of VAP.

RESULTS

The incidence of ventilator-associated pneumonia (VAP) was 32.9 % in the cohort. Mortality was significantly higher among patients with VAP (40.00 % vs. 26.10 %, p = 0.033). In unadjusted analyses, the administration of IVIG within 30 days before intubation was associated with a lower incidence of VAP (27.54 % vs. 41.11 %, p = 0.033) and a reduced rate of Acinetobacter baumannii infection (2.9 % vs. 15.6 %, p = 0.001). After adjusting for potential confounders, IVIG administration remained independently associated with a substantially reduced risk of VAP (aOR = 0.448, 95 % CI: 0.288-0.697, p < 0.001). Conversely, tracheotomy, underlying conditions, and malnutrition were among the factors associated with an increased risk.

CONCLUSIONS

IVIG administration within one month prior to ventilation may be associated with a reduced incidence of VAP.