Risk factors for mortality in pediatric acute respiratory distress syndrome requiring extracorporeal membrane oxygenation support
10.3760/cma.j.cn112140-20210222-00148
- VernacularTitle:体外膜肺氧合下儿科急性呼吸窘迫综合征死亡危险因素分析
- Author:
Huiling ZHANG
1
;
Zhichun FENG
;
Ye CHENG
;
Zhe ZHAO
;
Yingfu CHEN
;
Chengjun LIU
;
Dongliang CHENG
;
Changsong SHI
;
Feng WANG
;
Jie WANG
;
Youpeng JIN
;
Yi YIN
;
Guoping LU
;
Xiaoyang HONG
Author Information
1. 南方医科大学第二临床医学院，广州 510515
- Keywords:
Extracorporeal membrane oxygenation;
Risk factors;
Retrospective studies
- From:
Chinese Journal of Pediatrics
2021;59(5):380-386
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors for mortality in pediatric acute respiratory distress syndrome (PARDS) requiring extracorporeal membrane oxygenation (ECMO) support.Methods:Clinical data of 109 patients with severe PARDS supported by ECMO, who were hospitalized in 6 ECMO centers in China from September 2012 to February 2020, were retrospectively analyzed. They were divided into survival group and death group according to the prognosis. Chi-square test and rank sum test were used to compare the variables between the two groups, including the demographic data, laboratory examination results, clinical data before and after ECMO, and other supportive treatment. Univariate and multivariate Logistic regression models were used to analyze the prognostic risk factors.Results:In these 109 cases, 54 died and 55 survived. Compared with the survival group, the death group had higher incidences of acute kidney injury (AKI) (48.1% (26/54) vs. 21.8% (12/55) , χ2=8.318, P=0.004) and coagulation dysfunction (22.2% (12/54) vs. 7.3% (4/55) , χ2=4.862, P=0.027), and higher rate of renal replacement therapy (48.1% (26/54) vs. 21.8% (12/55) , χ2=9.694, P=0.008) during ECMO support. Logistic regression analysis showed that continuous renal replacement therapy (CRRT) and AKI were independent risk factors for death in patients with severe PARDS requiring ECMO support ( HR=3.88,95% CI 1.04-14.52, HR=4.84,95% CI 1.21-19.46, both P<0.05). Conclusion:AKI and CRRT are independent risk factors for predicting mortality in patients with severe PARDS requiring ECMO support.
