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The following is a summary of “Down syndrome and outcomes in critically ill pediatric patients,” published in the January 2025 issue of Pediatrics by Fieno et al. 

Researchers conducted a retrospective study to examine the association between down syndrome (DS) and clinical outcomes in children admitted to the pediatric intensive care unit (PICU) at the Instituto Nacional de Salud del Niño (INSN) (national institute for child health) and to evaluate their nutritional status.  

They performed a secondary analysis of a database, including all children consecutively admitted to INSN, a tertiary care hospital in Lima, Peru. Demographic data, clinical characteristics, and nutritional status were recorded in standardized tables. Outcomes evaluated included mortality, length of stay, duration of mechanical ventilation (DMV), ventilator-free days (VFD), and healthcare-associated infections (HAI). Cox and Poisson regression analyses were used to examine associations between DS and clinical outcomes, with both crude and adjusted results provided.  

The results showed 525 children (mean age 71.3 months, range 1–218 months) with DS were younger, had more comorbidities and congenital heart disease, and were more often underweight. Both crude bivariate and multivariate analyses indicated higher mortality, more HAIs, longer DMV, extended PICU stays, and fewer VFD among children with DS. Adjusted multivariate analysis confirmed a significantly higher risk of HAIs (RR 2.95; 95% CI 1.10, 7.87) and longer DMV (RR 1.43; 95% CI 1.24, 1.65). Underweight status in the cohort was linked to increased use of MV and prolonged DMV.  

Investigators concluded children with critical illness and DS were more likely to experience HAIs and prolonged MV, and underweight children in the study cohort were at higher risk of requiring MV and experiencing longer ventilation times. 

Source: frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1483944/full