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

Ko, Jung-Min (Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan)
Ha, Eun-Ju (Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan)
Lee, Eun-Hee (Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan)
Lee, So-Youn (Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan)
Kim, Hyo-Bin (Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan)
Hong, Soo-Jong (Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan)
Park, Seong-Jong (Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan)
Publication Information
Clinical and Experimental Pediatrics / v.48, no.6, 2005 , pp. 599-605 More about this Journal
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 nonsurvivors in $PaO_2/FiO_2$ 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.
Keywords
Acute respiratory distress syndrome; Clinical outcome; Prognostic factor;
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