Epidemiology of Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit: Single-center Experience.

IF 1.5
Chandrakant G Pujari, A V Lalitha, John Michael Raj, Ananya Kavilapurapu
{"title":"Epidemiology of Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit: Single-center Experience.","authors":"Chandrakant G Pujari,&nbsp;A V Lalitha,&nbsp;John Michael Raj,&nbsp;Ananya Kavilapurapu","doi":"10.5005/jp-journals-10071-24285","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) is characterized by dysregulated inflammation resulting in hypoxemia and respiratory failure and causes both morbidity and mortality.</p><p><strong>Objectives: </strong>To describe the clinical profile, outcome, and predictors of mortality in ARDS in children admitted to the Pediatric intensive care unit.</p><p><strong>Materials and methods: </strong>This is a single-center retrospective study conducted at a tertiary referral hospital in a 12-bed PICU involving children (1 month to 18 years) with ARDS as defined by Pediatric Acute Lung Injury Consensus Conference (PALICC) guidelines, over a period of 5 years (2016-2020). Demographic, clinical, and laboratory details at onset and during PICU stay were collected. Predictors of mortality were compared between survivors and non-survivors.</p><p><strong>Results: </strong>We identified 89 patients with ARDS. The median age at presentation was 76 months (12-124 months). The most common precipitating factor was pneumonia (66%). The majority of children (35.9%) had moderate ARDS. Overall mortality was 33% with more than half belonging to severe ARDS group (58%). On Kaplan-Meier survival curve analysis, the mean time to death was shorter in the severe ARDS group as compared to other groups. Multiorgan dysfunction was present in 46 (51.6%) of the cases. Non-survivors had higher mean pediatric logistic organ dysfunction (PELOD2) on day 1. PRISM III at admission, worsening trends of ventilator and oxygenation parameters (OI, P/F, MAP, and PEEP) independently predicted mortality after multivariate analysis.</p><p><strong>Conclusion: </strong>High PRISM score predicts poor outcome, and worsening trends of ventilator and oxygenation parameters (OI, P/F, MAP, and PEEP) are associated with mortality.</p><p><strong>How to cite this article: </strong>Pujari CG, Lalitha AV, Raj JM, Kavilapurapu A. Epidemiology of Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit: Single-center Experience. Indian J Crit Care Med 2022;26(8):949-955.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"949-955"},"PeriodicalIF":1.5000,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/a8/ijccm-26-949.PMC9363796.pdf","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-10071-24285","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 2

Abstract

Background: Acute respiratory distress syndrome (ARDS) is characterized by dysregulated inflammation resulting in hypoxemia and respiratory failure and causes both morbidity and mortality.

Objectives: To describe the clinical profile, outcome, and predictors of mortality in ARDS in children admitted to the Pediatric intensive care unit.

Materials and methods: This is a single-center retrospective study conducted at a tertiary referral hospital in a 12-bed PICU involving children (1 month to 18 years) with ARDS as defined by Pediatric Acute Lung Injury Consensus Conference (PALICC) guidelines, over a period of 5 years (2016-2020). Demographic, clinical, and laboratory details at onset and during PICU stay were collected. Predictors of mortality were compared between survivors and non-survivors.

Results: We identified 89 patients with ARDS. The median age at presentation was 76 months (12-124 months). The most common precipitating factor was pneumonia (66%). The majority of children (35.9%) had moderate ARDS. Overall mortality was 33% with more than half belonging to severe ARDS group (58%). On Kaplan-Meier survival curve analysis, the mean time to death was shorter in the severe ARDS group as compared to other groups. Multiorgan dysfunction was present in 46 (51.6%) of the cases. Non-survivors had higher mean pediatric logistic organ dysfunction (PELOD2) on day 1. PRISM III at admission, worsening trends of ventilator and oxygenation parameters (OI, P/F, MAP, and PEEP) independently predicted mortality after multivariate analysis.

Conclusion: High PRISM score predicts poor outcome, and worsening trends of ventilator and oxygenation parameters (OI, P/F, MAP, and PEEP) are associated with mortality.

How to cite this article: Pujari CG, Lalitha AV, Raj JM, Kavilapurapu A. Epidemiology of Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit: Single-center Experience. Indian J Crit Care Med 2022;26(8):949-955.

Abstract Image

Abstract Image

儿科重症监护病房急性呼吸窘迫综合征的流行病学:单中心经验。
背景:急性呼吸窘迫综合征(ARDS)以炎症失调导致低氧血症和呼吸衰竭为特征,可导致发病率和死亡率。目的:描述儿科重症监护病房收治的ARDS患儿的临床特征、结局和死亡率预测因素。材料和方法:这是一项单中心回顾性研究,在一家三级转诊医院的12个床位的PICU中进行,涉及儿童(1个月至18岁)急性呼吸窘迫综合征患儿,根据儿科急性肺损伤共识会议(PALICC)指南的定义,为期5年(2016-2020)。收集发病和PICU期间的人口学、临床和实验室细节。比较幸存者和非幸存者之间的死亡率预测因子。结果:我们确定了89例ARDS患者。就诊时的中位年龄为76个月(12-124个月)。最常见的诱发因素是肺炎(66%)。大多数儿童(35.9%)为中度ARDS。总死亡率为33%,其中一半以上属于严重ARDS组(58%)。Kaplan-Meier生存曲线分析显示,重度ARDS组平均死亡时间较其他组短。46例(51.6%)存在多器官功能障碍。非幸存者在第1天有较高的平均儿科逻辑器官功能障碍(PELOD2)。入院时PRISM III、呼吸机和氧合参数(OI、P/F、MAP和PEEP)恶化趋势独立预测多因素分析后的死亡率。结论:PRISM评分高预示预后差,呼吸机及氧合参数(OI、P/F、MAP、PEEP)恶化趋势与死亡率相关。Pujari CG, Lalitha AV, Raj JM, Kavilapurapu A.儿科重症监护病房急性呼吸窘迫综合征的流行病学:单中心经验。中华检验医学杂志;2009;26(8):949-955。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信