ARDS in children at Prapokklao Hospital.

Abstract

Objectives : To describe the prevalence, predisposing factors, mortality and morbidity of a 4 year experience in children with ARDS at Prapokklao Hospital.

Methods : The medical records diagnosed as ARDS at Pediatric intensive care unit were retrospectively studied from 2000 to 2004. 30 children met the American-European Consensus Conference definitions for acute lung injury and acute respiratory distress syndrome.

Results : The prevalence rate of ARDS was 3.3 percent of the pediatric patients admitted at PICU. The common predisposing factors were submersion,sepsis, malignancy, pneumonia and malaria respectively. The mortality rate was 73.3 percent. The means of age, maximal PIP and PEEP, initial PCO2, PaO2/FiO2, A-aDO2 and ventilation index did not predict the mortality. But PIM score (Pediatric Index of Mortality) of the non-survivors was significantly greater than the survivors (p=.034). The common complications were renal complication (33.3 percent) and pulmonary air leak from ventilator (23.2 percent).

Conclusions : The predisposing factors of children in our study were not different from the adults. Our mortality rate was still high. To declined this mortality rate,the physicians should concern the pathophysiology of ARDS and the effects of mechanical ventilation on the lung and the novel ventilation strategies.