Hyperoxemia Among Ventilated children and its Impact on Outcome in A Tertiary Care Hospital

BACKGROUND: The Oxygen is one of the most important therapy in PICU specially when it comes to mechanical ventilation which is required for various diseases especially respiratory as it is amongst the most common cause of PICU admission with significantly higher contribution . Oxygen therapy, though essential, is frequently administered without stringent controls, potentially leading to unintended adverse outcomes so we determine the frequency of Hyperoxia and its outcomes in mechanically ventilated children admitted in a paediatric intensive care unit. METHODS : Prospective cross-sectional study in PICU of Aga khan university hospital Karachi we included All children aged one month to 18 years who received mechanical ventilation for more than 24 hours from October 2023 to march 2024.Children with extubation failure, congenital heart disease, and with chronic respiratory conditions were excluded Normally distributed continuous variables were reported as mean ± SD, while non-normally distributed continuous or discrete variables were reported as median (IQR). At the univariate level, a generalized linear model was used for binary outcomes and quasi-Poisson regression was used for discrete outcome. Odds ratio (OR) and Incidence Rate Ratio (IRR) were reported with 95% CI interval. A P-value less than 0.05 was considered as statistically significant. RESULTS: The frequency of hyperoxemia in our study is 84.6% with higher quartiles of CEOE were significantly associated with increased mortality and MODS, Specifically, patients in Quartile 4 had an odds ratio (OR) of 4.73 [95% CI: 1.59–14.7] for mortality and 3.62 [95% CI: 1.37–9.98] for MODS and increased length of stay risks increased significantly in higher CEOE quartile 4 (OR 1.53[1.16 – 2.02]). CONCLUSIONS : hyperoxemia is much prevalent is PICU settings with mechanical ventilation and there is significant association between CEOE and adverse effect in the form of mortality, length of stay and multiorgan dysfunctions.