Coagulopathy as a Prognostic Factor of Acute Lung Injury in Children.
10.3346/jkms.2012.27.12.1541
- Author:
Young Joo HAN
1
;
June Dong PARK
;
Jae Wook CHOI
;
Dong In SUH
;
Young Yull KOH
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. jdparkmd@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Acute Lung Injury;
Acute Respiratory Distress Syndrome;
Coagulopathy;
Prothrombin Time;
Partial Thromboplastin Time;
Prognosis
- MeSH:
Acute Lung Injury/*etiology/mortality;
Adolescent;
Blood Coagulation Disorders/*complications;
Child;
Child, Preschool;
Female;
Humans;
Infant;
Infant, Newborn;
Male;
Multivariate Analysis;
Partial Thromboplastin Time;
Prognosis;
Prothrombin Time;
Respiratory Distress Syndrome, Adult/*etiology/mortality;
Retrospective Studies;
Survival Rate;
Young Adult
- From:Journal of Korean Medical Science
2012;27(12):1541-1546
- CountryRepublic of Korea
- Language:English
-
Abstract:
The coagulation cascade and inflammatory process are known to be associated with the pathophysiology of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). We retrospectively investigated laboratory values indicating coagulopathy obtained within 24 hr from diagnosis of ALI/ARDS in 79 children who received mechanical ventilation between 2008 and 2009 and their final outcomes. Prothrombin time (PT) (P = 0.001) and activated partial thromboplastin time PTT (APTT) (P = 0.001) were more prolonged in non-survivors than survivors (mean; 1.57 vs 1.33; 63 vs 57). In multivariate analysis with stratification by oxygenation-index (< 14.5, > or = 14.5), prolonged PT (> or = 1.46 international normalized ratio, [INR]) (hazard ratio; 2.043, 1.027-4.064) was associated with lower non-pulmonary-organ-failure-free survival rate (FFS), and prolonged APTT (> or = 50 seconds) (2.062, 1.031-4.121; 2.422, 1.227-4.781) was associated with lower overall survival rate (OS) and lower FFS. In stratification by ventilation-index (< 40, > or = 40), prolonged PT (2.232, 1.095-4.540; 2.177, 1.092-4.342) and prolonged APTT (2.574, 1.230-5.386; 3.089, 1.500-6.360) were associated with lower OS and lower FFS. Prolonged PT and APTT are associated with mortality in mechanically ventilated children with ALI/ARDS. We suggest PT and APTT as prognostic factors of ALI/ARDS in children.
