Epidemiology and Outcome of Pediatric Acute Respiratory Distress Syndrome According to Pediatric Acute Lung Injury Consensus Conference 2015 (PALICC) Definition: A single center Prospective Study
Journal Title: Journal Of Pediatric Critical Care - Year 2017, Vol 4, Issue 4
Abstract
Background: The term Acute respiratory distress syndrome (ARDS) describes a syndrome of acute onset, characterized by respiratory distress, bilateral pulmonary infi ltrates with decreased pulmonary compliance and hypoxaemia. Recent data indicate that ARDS occurs in 1-4% of PICU admissions and as many as 8-10% of children requiring mechanical ventilation. Mortality for Pediatric ARDS has varied between 20 and 75%. Despite very high incidence in PICU with high mortality and morbidity there are only few studies on Pediatric ARDS. Hence the present study is undertaken to elucidate the epidemiology, etiological profi le and outcome of pediatric ARDS admitted to our PICU. Objective: To study the Epidemiology and Outcome of Pediatric Acute Respiratory Distress Syndrome according to Pediatric Acute Lung Injury Consensus Conference 2015 (PALICC) Defi nition. Material and Methods: This was Single centre Prospective observational study. All children between the age group of 1 month to 15 years admitted to pediatric intensive unit with respiratory distress meeting PALICC 2015 Pediatric ARDS criteria consisted as the study group. Children with mild respiratory distress were started on high fl ow nasal cannula or NIV. Children with moderate to severe respiratory distress were started on mechanical ventilation. Severity of ARDS was assessed with oxygenation index. All children with ARDS were managed with PALICC 2015 recommendation. All data was collected in a systematically designed proforma and analysed. Results: A total of 652 children got admitted in high dependency PICU between January 2017 to July 2017. Of these 39 (5.98%) children fulfi lled the PALICC 2015 Pediatric ARDS criteria. Out of 39 children with Pediatric ARDS, majority (46%) of them were between age group of 1 to 5 years. Pneumonia was most common risk factor for ARDS (51%) in our study. Thirty one children were mechanically ventilated. Among ventilated children 8 (20.5%) had mild, 15 (38%) had moderate and 8 (41%) had severe ARDS Overall mortality was 12 (30.76%). Five out of 8 (62%) children with severe ARDS have expired. Adjunct therapies used in study group were, steroids in 5 (16%) cases , neuromuscular blockers in 6 (15.3%) cases and prone ventilation 1 case. Conclusion: Pediatric ARDS is an illness with high mortality and requires excellent supportive care. Pneumonia is the commonest risk factor for development of pediatric ARDS. Risk factors for mortality include presence of comorbidities, multi organ dysfunction and high OI at 24 hours of ARDS.
Authors and Affiliations
Basavaraj G V, Vinayaka H S, Tummala Sujith Kumar, Asha Benakappa
Keywords
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- EP ID EP336098
- DOI 10.21304/2017.0404.00209
- Views 50
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