J Korean Pediatr Soc.
2003 Jan;46(1):42-50.
A Clinical Study of the Acute Respiratory Distress Syndrome in Children
- Affiliations
-
- 1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. dskim6634@yumc.yonsei.ac.kr
- 2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
Abstract
- PURPOSE
The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. METHODS: Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. RESULTS: A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune ompromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, PaO2, PaCO2, PEEP, and PaO2/FiO2 on the seventh day after the onset of the ARDS. CONCLUSION: According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.
