Mechanical Ventilation Strategies of Suspected COVID-19 Patients in Pediatric Intensive Care Unit

Abstract

Background: Paediatric patients with COVID-19 often require specialized mechanical ventilation (MV) approaches, particularly when presenting with respiratory complications. This work aimed to assess different ventilation strategies in pediatric intensive care for COVID-19 sufferes.

Methods: A prospective work had been performed on 120 paediatric patients (1-72 months) admitted to the Paediatric Intensive Care Unit, had been allocated into six groups depending on their clinical conditions and ventilation strategies: COVID-19-suspected on conventional MV (Group I) or high-frequency oscillatory ventilation (HFOV) (Group II), non-COVID ARDS on conventional MV (Group III) or HFOV (Group IV), and non-COVID/non-ARDS on conventional MV (Group V) or HFOV (Group VI).

Results: COVID-19 patients showed significantly higher Oxygenation Index (OI) and Oxygen Saturation Index (OSI) compared to non-COVID groups. The PaO₂/FiO₂ (P/F) and SpO₂/FiO₂ (S/F) ratios were significantly lower in COVID-19 groups. The S/F ratio demonstrated predictive value for ventilation duration (cutoff >165, sensitivity 64%, specificity 60%) and mortality (cutoff >176, sensitivity 72%, specificity 64%).

Conclusions: COVID-19 pediatric patients exhibit distinct ventilation parameters compared to non-COVID patients, with the S/F ratio serving as a potential indicator for ventilation duration and fatality.