Outcomes and predictors of respiratory morbidity in children with neuromuscular disorders requiring respiratory support: a cohort study from Vietnam

Abstract

Background Respiratory failure is a major cause of intensive care admission in children with neuromuscular disorders, but data on outcomes and prognostic factors in mixed pediatric neuromuscular cohorts remain limited. This study aimed to describe short-term outcomes and identify predictors of poor outcomes in children with neuromuscular disorders requiring respiratory support in a tertiary pediatric intensive care unit. Methods We conducted a single-center cohort study of children aged 1 month to 16 years with neuromuscular disorders requiring respiratory support admitted to a tertiary pediatric intensive care unit in Vietnam between January 2023 and June 2025. Poor outcome was defined as in-hospital mortality, invasive mechanical ventilation for ≥7 days, tracheostomy, or reintubation. Results Sixty-three children were included. In-hospital mortality was 14.3% (9/63), and 33 children (52.4%) experienced a poor outcome. Nineteen children (30.2%) required invasive mechanical ventilation for ≥7 days, 10 (15.9%) underwent tracheostomy, and 20 (31.7%) required reintubation. Higher Pediatric Risk of Mortality III (PRISM III) score, shock, lower Glasgow Coma Scale score, and older age were independently associated with poor outcomes. Conclusions Respiratory morbidity was substantial among children with neuromuscular disorders requiring respiratory support. Early illness severity and physiological instability at PICU admission were independently associated with poor outcomes.