Clinical Outcome and Prognostic Factors of Acute Respiratory Distress Syndrome in Children

Ko, Jung Min; Ha, Eun Ju; Lee, Eun Hee; Lee, So Youn; Kim, Hyo Bin; Hong, Soo Jong; Park, Seong Jong

Abstract

PURPOSE
The purpose of this study was to examine the causes, clinical courses and outcomes in children with acute respiratory distress syndrome (ARDS), and evaluate the physiologic variables as prognostic factors in the patients. METHODS: Retrograde medical chart review was carried out in 24 patients who were diagnosed with ARDS at the pediatric intensive care unit (PICU) during 20-month period. RESULTS: The incidence of ARDS among all PICU admission was 3.7 percent and the mortality rate was 37.5 percent, which was 14.8 percent of overall deaths in PICU. The most common causes of ARDS were pneumonia and sepsis. We found significant differences between survivors and non- survivors in PaO2/FiO2 ratio (P/F ratio), alveolar arterial oxygen gradient and oxygenation index (OI) on the second day from the onset of ARDS. Therapies for ARDS such as high frequency oscillator ventilation (HFOV), recruitment maneuver and low dose corticosteroid improved the P/F ratio and OI, especially in survivors CONCLUSION: The mortality rate of children with ARDS was 37.5 percent; an important cause of death in PICU. HFOV, recruitment maneuver and low dose corticosteroid seemed to be effective in pediatric ARDS. The P/F ratio, alveolar arterial oxygen gradient and OI on the second day from the onset of ARDS may be useful as prognostic factors.