Allergy Asthma Respir Dis.  2018 Mar;6(2):103-109. 10.4168/aard.2018.6.2.103.

Characteristics and prognostic factors of previously healthy children who required respiratory support in a pediatric intensive care unit

• Jung M
• Kim M
• Lee OJ
• Choi AY
• Hwang T
• Cho J

• KMID: 2408806
• DOI: http://doi.org/10.4168/aard.2018.6.2.103

Abstract

PURPOSE
Comorbidities have been considered a mortality risk factor in pediatric critical care patients. We studied the characteristics and prognostic factors of children without comorbidities who were admitted to the intensive care unit (ICU) due to respiratory failure.
METHODS
We reviewed the medical charts of patients (< 18 years) admitted to the ICU for respiratory support in a single tertiary center between January 2006 and December 2016. Patients with comorbidities and perioperative statuses were excluded.
RESULTS
Of the 4,712 ICU patients, 73 (1.5%) were included in this study. The median age was 31 months (8-57) and 51 (69.9%) were boys. Twenty-nine patients (39.7%) presented with pneumonia, 14 (19.2%) with acute respiratory distress syndrome (ARDS), and 11 (15.1%) with obstructive airway disease. The median duration of ICU hospitalization was 5 days (2-14.5), and 45 of the 73 patients (61.6%) needed mechanical ventilation. Mortality was 13.7% (10/73). None of the patients with pneumonia or obstructive airway disease died. The most frequent cause of death was ARDS (5 of 10, 50%). In adjusted analysis, the extent of extrapulmonary organ dysfunction was significantly associated with mortality (odds ratio, 2.89; 95% confidence interval, 1.17-7.11; P=0.023).
CONCLUSION
The mortality rate of previously healthy pediatric patients needing respiratory support in the ICU should not be negligible. Multiple organ dysfunctions might be a significant risk factor for mortality in such patients.

Keyword

Child; Respiratory insufficiency; Comorbidity; Critical care; Mortality

MeSH Terms

Cause of Death
Child*
Comorbidity
Critical Care*
Hospitalization
Humans
Intensive Care Units*
Mortality
Pneumonia
Respiration, Artificial
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency
Risk Factors

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