Aims & Objectives:
Our objective was to determine the prevalence of Acute Respiratory Distress Syndrome (ARDS) and compare outcomes by using Pediatric Acute Respiratory Distress Syndrome (PARDS) definition and Berlin definition.
We screened case records of all children aged 1 month to 17 years of age admitted to the Pediatric Intensive Care Unit (PICU) over a 3 year period (2015- 2017) for presence of respiratory difficulty at admission or during PICU stay. We applied both PARDS and Berlin definition to these patients. Data collection included definition and outcome related variables. Data were compared between the ‘PARDS alone’ group and the ‘Berlin with or without PARDS’ group using Stata 11.
Of a total of 615 admissions, 246 were identified as having respiratory difficulty at admission or during PICU stay. The prevalence of ARDS in our PICU was 9.9% (95% CI: 7.8 – 12.4) with either criteria. Prevalence of ARDS with PARDS definition was 9.75% (6.1, 11.8) and with Berlin definition was 4.2% (2.9, 6.1) (p <0.001). There was poor agreement between the two (Kappa: -0.033).There was no difference between the two groups with regard to key clinical outcomes such as duration of ventilation (7 vs. 8 days), PICU stay (7 vs. 8 days) or mortality (51.7% vs. 57.7%).
In comparison to Berlin definition, the PARDS definition identified more number of patients with ARDS. There were no differences in key clinical outcomes between the groups.