Effects of Fluid Balance and Other Related Factors on the Length of Hospital Stay and Mechanical Ventilation Time in Children with Severe Pneumonia

MA Tao; CHANG Junli; SUN Xiaoyu; SHI Changsong

doi:10.3969/j.issn.1004-437X.2025.16.006

Abstract：Objective Analyzing the effects of fluid balance and other related factors on the length of hospital stay and mechanical ventilation time in children with severe pneumonia.Methods A retrospective analysis was conducted on 111 children with severe pneumonia admitted to the Pediatric Intensive Care Unit(PICU)of the Henan University People's Hospital of from December 2017 to January 2024,collecting the general date,first-week fluid intake and output,mechanical ventilation time,PICU stay time,and total hospital stay of the patients.The patients were divided into three groups based on the cumulative fluid balance(＜0％,0～5％,＞5％),and the differences in acute physiology and chronic health evaluation(APACHE Ⅱ)score,pediatric critical illness score(PCIS)score,total hospital stay,and PICU stay were compared between the three groups on the 3rd and 5th days.Multivariate linear regression analysis was used to analyze the influencing factors of hospital stay and mechanical ventilation time in children with severe pneumonia.Results(1)There were statistical differences in hospital stay and PCIS score among the three groups on the 3rd and 5th days(P＜0.05),but no statistical difference was found in APACHE Ⅱ score among the three groups on the 3rd day and on the 5th day(P＜0.05).(2)There were statistically significant differences in hospitalization time and PCIS scores between groups on the 3rd and 5th days(P＜0.05),while the APACHE Ⅱ score only showed a statistically significant difference between groups on the 5th day(P=0.019).There was no statistically significant difference in PICU hospitalization time between groups.Pairwise comparisons between groups(group 1 vs group 3):on the 3rd day,the group with cumulative fluid balance＞5％had a shorter hospitalization time(P=0.009)and a higher PCIS score(P=0.020);on the 5th day,the group with cumulative fluid balance＞5％had a higher PCIS score(P=0.048)and a lower APACHE Ⅱ score(P=0.018).(3)Multiple linear regression showed that for each 1-point increase in the PCIS score,the hospitalization time was shortened by 0.716 days(b=-0.716,P＜0.001),and the mechanical ventilation time was shortened by 10.334 hours(b=-10.334,P＜0.001).Conclusion Early cumulative fluid balance is not related to the hospital stay and mechanical ventilation time of children with severe pneumonia,and PCIS score is an important factor affecting the hospital stay and mechanical ventilation time of children with severe pneumonia.