Severe Community-Acquired Pneumonia: Admissions to the Pediatric Intensive Care Unit in Camagüey

Abstract

Introduction: Pneumonia is the leading cause of childhood mortality worldwide. In Cuba, it is also a significant health problem.

Objective: To describe the clinical and epidemiological characteristics and clinical course of children with severe community-acquired pneumonia admitted to the pediatric intensive care unit in Camagüey.

Methods: A descriptive, cross-sectional, observational study was conducted on patients between one month and 18 years of age with severe community-acquired pneumonia admitted to the intensive care unit of the Pediatric Hospital of Camagüey from January 2017 to December 2023. The variables studied were age, sex, complications, medical-surgical procedures, length of stay, and mortality.

Results: Six hundred twenty-three children were admitted, the majority were under five years of age (75,7 %). Intrathoracic complications predominated, with parapneumonic pleural effusion being the most frequent. Sepsis was the main extrathoracic complication. The most frequently used procedures were chest tube insertion, video-assisted thoracoscopic surgery (VATS), and intrapleural Heberkinase®. 7.5 % of all patients required invasive mechanical ventilation, 80,6 % had an intensive care unit (ICU) stay of seven days or less, and the mortality rate was 3,4 %.

Conclusions: Severe community-acquired pneumonia was a frequent cause of admission to the ICU, with children under five years of age being the most affected. Pleural effusion and sepsis occurred in more than one-third of the patients; chest tube insertion was the most frequently used procedure, and the use of VATS decreased during the administration of intrapleural Heberkinase®. Mortality was low.