The Devastating Effect of Secondhand Smoking Exposure in Pediatric Intensive Care Admissions

Year 2019, Volume: 13 Issue: 5, 353 - 357, 23.09.2019

Mutlu Uysal Yazıcı , Selman Kesici Filiz Yetimakman , Murat Tanyıldız , Benan Bayrakçı

https://doi.org/10.12956/tchd.594182

Abstract

Background: The
aim of this study was to evaluate the effect of secondhand parental smoking in pediatric
intensive care unit patients.

Methods: This
cross sectional prospective survey study was conducted as a questionnaire
regarding the smoking habits of all parents of hospitalized patients in our pediatric
intensive care unit between September 2014 and January 2015. We studied the prevalence
and potential effects of secondhand parental smoking on the diagnosis, severity
of disease, duration of hospitalization and length of stay on mechanical
ventilation.

Results: A
total of 125 female and 178 male were included in the study. The median age was
53 (min:1 - max: 216) months. Indications of hospitalizations were intoxication
(16.5%), neurological disorders (14.9%), malignancy (12.9%), congenital heart
diseases (11.2%), genetic syndromes (9.9%), trauma (9.6%), shock (%7.3),
arrhythmia (6.3%), renal failure (5%), diabetes (2.6%), burns (2.6%) and
metabolic diseases (%1.3). A total of 42.2% of patients were on invasive, 5.3%
were on non-invasive mechanical ventilation. Mothers, fathers and guests
smoking rates were 40.6%; 75.2% and 58.4% respectively. The rate of illiterate
fathers and mothers were higher in secondhand parental smoking group compared
with non-exposure group (6% vs 4%, p=0.004, 10.7% vs 5.7%, p=0.21,
respectively). The secondhand parental smoking rate was 76.9% whereas the smoking prevalence in Turkey was determined to be
30.5% for the whole population reflecting an increased velocity of PICU
admissions. The secondhand parental smoking rate of children diagnosed
as malignancy was 16.4% compared with non-exposed group (1.4%) which was
statistically significant (p<0.05). There was no significant difference in
secondhand parental smoking rate was of children diagnosed as intoxication,
trauma, burns and others. The mean length of stay in MV and Pediatric Risk of Mortality (PRISM)  score
were 5.8 days ± 6.3 and 11.6 ± 8 respectively.. The
PRISM score was statistically significant in secondhand parental
smoking exposed children compared with non-exposed ones ( 12.2 ± 7.9 vs 9.6 ±
7.8 ; p= 0.007). The length of stay in pediatric intensive care unit (PICU) and
duration of mechanical ventilation were longer in children secondhand smoking
exposure (p<0.05).

Conclusion: Secondhand
smoking is related with increased velocity of PICU admissions, severity of
disease, increased diagnosis of malignancies, prolonged duration of mechanical
ventilation and PICU stay. Besides, secondhand exposed patients are more likely
to have low parental education level.

Keywords

Smoking exposure, pediatric intensive care unit, parents

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