Comparison of clinical characteristics and outcomes of infants with moderate and severe acute respiratory distress syndrome diagnosed according to baseline oxygenation index
10.3760/cma.j.issn.1673-4912.2023.08.001
- VernacularTitle:按照基线氧合指数诊断的中度和重度急性呼吸窘迫综合征婴幼儿的临床特点和预后比较
- Author:
Boliang FANG
1
;
Kechun LI
;
Feng XU
;
Guoping LU
;
Xiaoxu REN
;
Yucai ZHANG
;
Youpeng JIN
;
Ying WANG
;
Chunfeng LIU
;
Yibing CHENG
;
Qiaozhi YANG
;
Shufang XIAO
;
Yiyu YANG
;
Ximin HUO
;
Zhixian LEI
;
Hongxing DANG
;
Shuang LIU
;
Zhiyuan WU
;
Jiansheng ZENG
;
Suyun QIAN
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童医院重症医学科 100045
- Keywords:
Pediatric;
Intensive care unit;
Mechanical ventilation;
Acute respiratory distress syndrome;
Oxygenation index
- From:
Chinese Pediatric Emergency Medicine
2023;30(8):561-565
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.
