A Clinical Study of the Acute Respiratory Distress Syndrome in Children.
- Author:
Taek Jin LEE
1
;
Dong Soo KIM
;
Dong Hwan SHIN
Author Information
1. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. dskim6634@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Acute respiratory distress syndrome;
Pediatric;
Mortality;
Respiratory failure
- MeSH:
Child;
Male;
Female;
Humans;
Incidence;
Mortality;
Risk Factors;
Bone Marrow Transplantation
- From:Journal of the Korean Pediatric Society
2003;46(1):42-50
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. METHODS: Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. RESULTS: A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune ompromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, PaO2, PaCO2, PEEP, and PaO2/FiO2 on the seventh day after the onset of the ARDS. CONCLUSION: According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.
