Abstracts of the 7th World Congress on Pediatric Critical Care
Background and aims: The incidence and outcome of the acute respiratory distress syndrome (ARDS) in children are not well-known, especially under current ventilatory practices.
Aims: The aim of this study was to precise incidence, causes, clinical features and outcome of children with ARDS.
Methods: The case records of children aged greater than 1 month and admitted to a university hospital pediatric intensive care unit (PICU) with ARDS from January 2009 to december 2010 were retrospectively reviewed and the data collected were analyzed.
Results: A total of 21 children were diagnosed as ARDS during the study period giving an incidence of 20.5/1,000 admissions. The mean age was 25.8 ± 44.5 months (range 1, 9 – 211). ARDS was caused by a primary lung pathology in 16 cases (76, 2%) while the rest of cases (23.8%) had non pulmonary causes. Nineteen children (90, 4%) were ventilated using Pressure Controlled Ventilation. The maximum PEEP used was 8,2 ± 1,5 cmH2O (range: 6–11); the maximum PIP used was 30 ± 4,7 cmH2O (range: 20–38). High frequency oscillatory ventilation (HFOV) was used in 13 patients (61, 9%). Two patients received only HFOV. The mean duration of mechanical ventilation was 7,5 ± 7,2 days (range: 0,5-32). The overall mortality was 66, 7%. Mortality was highest in children with a primary lung pathology than in those with non pulmonary causes (75% vs 40%; p = 0,28).
Conclusions: ARDS had a high mortality in the PICU, especially in patients with primary lung pathology. Adequate management including lung protective ventilation strategy is required.