Clinical outcomes of immunocompromised children with acute respiratory distress syndrome
10.3760/cma.j.issn.1671-0282.2018.04.019
- VernacularTitle:免疫低下儿童合并急性呼吸窘迫综合征的预后
- Author:
Zhaoni WANG
1
;
Zhuanggui CHEN
;
Yueyu SUN
;
Yan HU
;
Yating LI
;
Yuxiong GUO
Author Information
1. 中山大学附属第三医院儿童重症监护室
- Keywords:
Immunocompromise;
Pediatrics;
Acute respiratory distress syndrome;
Outcomes;
mortality;
Ventilator-associated lung injury;
Survival analysis;
Critical care medicine;
Mechanical ventilation
- From:
Chinese Journal of Emergency Medicine
2018;27(4):430-435
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical outcomes of immunocompromised (IC) children with pediatric acute respiratory distress syndrome (PARDS) in pediatric intensive care unit (PICU).Methods Fifty-six PADRS children were enrolled and the data of clinical characteristics,immunological status,complications,treatments and outcomes were collected and analyzed by using univariate and multivariate regression models.Results There were 20 children in the immunocompromised group and 36 in the control group.Immunocompromised children were older and weighted greater than the control ones (P=0.003 and P＜0.01,respectively).Peripheral blood leukocyte,neutrophil and platelet counts were significantly lower in IC group compared with control group (P=0.060,P=0.006 and P=0.023,respectively).In addition,high-frequency oscillatory ventilation (HFOV) was used less frequently in the IC group (P=0.015).The PICU mortality of the IC group was significantly higher than that of control group (P=0.003).The proportion of IC patients and the incidence of ventilator-associated lung injury differed significantly between survivors and non-survivors (P=0.003 and P=0.046,respectively).After adjusting for other confounding factors by using multivariate logistic regression analysis,IC was associated with a higher mortality (OR=6.986,95％ CI:1.812-26.930,P=0.005).Survival analysis also indicated that IC children with ARDS had lower 28-day survival rate than the non-IC children (P=0.022).Conclusions IC children with PARDS have a higher PICU mortality than children with normal immune function.Immunocompromise is an important predictor of poor outcomes in children with PARDS.
