Clinical Outcome of Pediatric Acute Respiratory Distress Syndrome
Keywords:
Acute respiratory distress syndrome, ARDSAbstract
Background: Acute respiratory distress syndrome (ARDS) is a diffuse inflammatory lung disease that is impaired gas exchange. Most common cause of ARDS was pneumonia. In Thailand, there was still limited research of pediatric ARDS and mostly conducted in university hospital.
Objective: To estimate the outcome of ARDS in pediatric intensive care unit (PICU) at Maharat Nakhon Ratchasima Hospital.
Methods: ARDS patients aged 29 days to 15 years who admitted to PICU during March 1st, 2018 to May 31st, 2019 and received mechanical ventilator at least 24 hours were enrolled. Data were collected daily until discharge from hospital or death. All patients were followed the standard of pediatric critical care management.
Results: There were 695 patients admitted to PICU. 126 patients did not meet inclusion criteria, 4 patients met exclusion criteria, and 27 patients were ARDS (3.9%). There were 18 male patients (66.7%), the median age was 2.4 years, the mean body weight was 22.7
kilograms. Most common cause was pneumonia (77.8%). Twenty-one patients died (77.8%). The risk factors of mortality were Acinetobacter baumannii, Pseudomonas aeruginosa and Klebseilla pneumoniae infection, severe ARDS, inotrope usage, high PRISM III score, high PELOD-2 score, and number of organ failure but there were no statistically significant.
Conclusion: 27 patients were ARDS (3.9%). Twenty-one patients died (77.8%). The risk factors of mortality were no statistically significant.
Downloads
References
Flori HR, Glidden DV, Rutherford GW, Matthay MA. Pediatric acute lung injury: prospective evaluation of risk factors associated with mortality. Am J Respir Crit Care Med 2005;171:995-1001.
Erickson S, Schibler A, Numa A, Nuthall G, Yung M, Pascoe E, et al; Paediatric Study Group, Australian and New Zealand Intensive Care Society. Acute lung injury in pediatric intensive care in Australia and New Zealand: a prospective, multicenter, observational study. Pediatr Crit Care Med 2007;8:317-23.
Kneyber MC, Brouwers AG, Caris JA, Chedamni S, Plotz FB. Acute respiratory distress syndrome: is it underrecognized in the pediatric intensive care unit?. Intensive Care Med 2008;34:751–4.
Yu WL, Lu ZJ, Wang Y, et al; Collaborative Study Group of Pediatric Respiratory Failure. The epidemiology of acute respiratory distress syndrome in pediatric intensive care units in China. Intensive Care Med 2009;35:136-43.
Li Y, Wang Q, Chen H, Gao HM, Zhou T, Qian SY. Epidemiological features and risk factor analysis of children with acute lung injury. World J Pediatr 2012;8:43-6.
López-Fernández Y, Azagra AM, de la Oliva P, et al; Pediatric Acute Lung Injury Epidemiology and Natural History (PEDALIEN) Network. Pediatric acute lung injury epidemiology and natural history study: incidence and outcome of the acute respiratory distress syndrome in children. Crit Care Med 2012;40:3238-45.
Wong JJ, Loh TF, Testoni D, Yeo JG, Mok YH, Lee JH. Epidemiology of pediatric acute respiratory distress syndrome in Singapore:
risk factor and predictive respiratory indices for mortality. Front Pediatr 2014;2:1-6.
Yehya N, Servaes S, Thomas NJ. Characterizing degree of lung injury in pediatric acute respiratory distress syndrome. Crit Care Med 2015;43:937-46.
Spicer AC, Calfee CS, Zinter MS, Khemani RG, Lo VP, Alkhouli MF, et al. A simple and robust bedside model for mortality risk in
pediatric patients with ARDS. Pediatr Crit Care Med 2016;17:907-16.
Yehya N, Thomas NJ. Disassociating lung mechanics and oxygenation in pediatric acute respiratory distress syndrome. Crit
Care Med 2017;45:1232-9 .
Wong JJ, Phan PH, Phumeetham S, et al; Pediatric Acute & Critical Care Medicine Asian Network (PACCMAN). Risk stratification in pediatric acute respiratory distress syndrome: a multicenter observational study. Crit Care Med 2017;45:1820-8.
Hu X, Qian S, Xu F, et al; Chinese Collaborative Study Group for Pediatric Respiratory Failure. Incidence, management, and mortality of acute hypoxemic respiratory failure and acute respiratory distress syndrome from a prospective study of Chinese paediatric intensive care network. Acta Pædiatrica 2010;99:715-21.
Barreira ER, Munoz GO, Cavalheiro PO, et al; Brazilian Pediatric Acute Respiratory Distress Syndrome Study Group. Epidemiology
and outcomes of acute respiratory distress syndrome in children according to the Berlin definition: a multicenter prospective study. Crit Care Med 2015;43:947-53.
Panico FF, Troster EJ, Oliveira CS, et al. Risk factors for mortality and outcomes in pediatric acute lung injury/acute respiratory distress syndrome. Pediatr Crit Care Med 2015;16:194-200.
Jouvet P, Thomas NJ, Willson DF; The Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the pediatric acute lung injury consensus conference. Pediatr
Crit Care Med 2015;16:428-39.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
