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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Critical Care
Volume 12 - 2024 | doi: 10.3389/fped.2024.1483944

DOWN SYNDROME AND OUTCOMES IN CRITICALLY ILL PEDIATRIC PATIENTS

Provisionally accepted
Jose A Tantalean Jose A Tantalean 1*Rosa J Leon Rosa J Leon 2Patricia Palomo Patricia Palomo 2,3Carlos M Del Aguila Carlos M Del Aguila 1Emiliana Rizo Patrón Emiliana Rizo Patrón 4
  • 1 National University Federico Villareal, Lima, Peru
  • 2 Instituto Nacional de Salud del Niño, Lima, Peru
  • 3 National University of San Marcos, Lima, Lima, Peru
  • 4 Universidad Peruana Cayetano Heredia, Lima, Peru

The final, formatted version of the article will be published soon.

    Introduction: Information regarding children with Down syndrome (DS) in the Pediatric Intensive Care Unit (PICU) is limited and conflicting. We aimed to investigate the association between DS and clinical outcomes in pediatric patients admitted to the PICU at the Instituto Nacional de Salud del Niño (National Institute for Child Health, INSN for the acronym in Spanish) and to assess nutritional status within the study cohort. Methods: This study involved the secondary analysis of a database. We included patients consecutively admitted to INSN, a tertiary care children's hospital in Lima, Peru. We collected demographic data, clinical characteristics, and nutritional status using standardized tables. The outcomes assessed included mortality, length of stay, duration of mechanical ventilation (DMV), ventilator-free days (VFD), and healthcare-associated infections (HAI). We applied Cox regression and Poisson regression analyses to explore the relationship between Down syndrome and clinical outcomes, providing both crude and adjusted results. Results: A total of 525 children (average age 71.3 months, range 1-218 months) were analyzed. Children with DS were younger and had a higher prevalence of comorbidities, congenital heart disease, and underweight. Both crude bivariate and multivariate analyses demonstrated that children with DS had higher mortality rates, increased frequency of HAIs, longer DMV, longer PICU stay, and fewer VFD. Adjusted multivariate analysis revealed that children with DS had a significantly higher risk of developing HAIs (RR 2.95; 95% CI 1.10, 7.87) and longer DMV (RR 1.43; 95% CI 1.24, 1.65). Among the 525 children, underweight was associated with increased risk of mechanical ventilation (MV) use and longer DMV. Discussion: Critically ill children with DS are at increased risk of developing HAIs and longer DMV. In all 525 children, underweight is associated with higher risk of MV use and longer duration of MV.

    Keywords: Down Syndrome, Pediatrics, Critical Care, cohort study, mechanical ventilation, Infections

    Received: 20 Aug 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Tantalean, Leon, Palomo, Del Aguila and Rizo Patrón. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jose A Tantalean, National University Federico Villareal, Lima, Peru

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.