Allergy Asthma Respir Dis.  2014 Sep;2(4):266-271. 10.4168/aard.2014.2.4.266.

Outcome of acute respiratory distress syndrome in children: a single center study

Affiliations
  • 1Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea. euneun99@gmail.com

Abstract

PURPOSE
This study aimed to determine the incidence, etiology, prognostic factors, and outcome of acute respiratory distress syndrome (ARDS) in children and to provide epidemiological data of children with ARDS treated at the pediatric intensive care unit (PICU) of a single center in Korea.
METHODS
We conducted a retrospective medical chart review of 19 children diagnosed with ARDS at the PICU of The Catholic University of Korea, Seoul St. Mary's Hospital, between March 2009 and February 2012.
RESULTS
Of the 334 PICU patients, 19 (5.6%) satisfied the American-European Consensus Conference definition of ARDS. Thirteen patients with ARDS died (mortality rate, 68.4%). Pneumonia was the most common cause of ARDS and observed in 10 patients (52.6%). There were significant differences between survivors and nonsurvivors in the PaO2/FiO2 ratio and the number of organ failure. The mortality rate was significantly higher in patients with a baseline PaO2/FiO2 ratio < or =100 mmHg than in those with a baseline PaO2/FiO2 ratio>100 mmHg (84.6% vs. 33.3%, P=0.046). We observed that a higher number of organ failure during the PICU stay, resulted in a higher mortality rate (P=0.037). Multiple logistic regression analysis showed that the PaO2/FiO2 ratio (adjusted odds ratio, 0.958) was independently associated with the increased risk of death after controlling for the number of organ failure.
CONCLUSION
The mortality rate of ARDS in children was 68.4% in this study, a higher rate than those reported in other national and international studies. The PaO2/FiO2 ratio at the time of ARDS onset was a helpful prognostic factor for predicting the mortality rate of children with ARDS.

Keyword

Outcome; Acute respiratory distress syndrome; Children

MeSH Terms

Child*
Consensus
Humans
Incidence
Intensive Care Units
Korea
Logistic Models
Mortality
Odds Ratio
Pneumonia
Respiratory Distress Syndrome, Adult*
Retrospective Studies
Seoul
Survivors

Figure

  • Fig. 1 Distribution of pediatric acute respiratory syndrome (ARDS) patients and mortality rate by the degree of hypoxemia (measured as PaO2/FiO2 ratio) at ARDS onset. Thirteen patients (68.4%) had a PaO2/FiO2 ≤100 mmHg. N, number of patients who died in each category; CI, confidence interval.

  • Fig. 2 Mortality of 19 pediatric acute respiratory syndrome patients in relation to the number of organ failure during pediatric intensive care unit stay, as represented by the number of patients who died in each category (N) and mortality for each category.


Cited by  2 articles

Characteristics and prognostic factors of previously healthy children who required respiratory support in a pediatric intensive care unit
Minyoung Jung¹, Minji Kim, Ok Jeong Lee, Ah Young Choi, Taewoong Hwang, Joongbum Cho
Allergy Asthma Respir Dis. 2018;6(2):103-109.    doi: 10.4168/aard.2018.6.2.103.

Literature review and future strategies of childhood respiratory diseases in Korea
Man Yong Han, Hai Lee Chung, Young Min Ahn, Jung Yeon Shim
Allergy Asthma Respir Dis. 2018;6(Suppl 1):S66-S76.    doi: 10.4168/aard.2018.6.S1.S66.


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