BACKGROUND: Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) represents a devastating complication observed in critical care medicine. The purpose of this study is to investigate the epidemiological aspects of ALI/ARDS in pediatric intensive care unit (PICU) and risk factors of mortality. METHODS: Patients with ALI/ARDS in PICU of Beijing Children's Hospital, a tertiary medical center from November 1, 2005 to October 31, 2006 were included in this prospective study. We identified the risk factors for underlying diseases and mortality during a 3-month followup using multivariate logistic regression analysis. RESULTS: In 562 critically ill patients admitted to PICU of Beijing Children's Hospital, there were 15 ALI-non ARDS patients and 29 ARDS patients, resulting in an incidence of 7.8% (44/562). The mortality rate of ARDS was 24.1% (7/29) and that of ALI/ARDS was 18.2% (8/44). At a 3-month follow-up, 12 patients died after being discharged from PICU and the total mortality rate was 45.5% (20/44). ALI/ARDS patients with pulmonary disease had better outcomes than those with extra-pulmonary involvements (P<0.05). Discharge against medical advice, low PaO(2)/FiO(2) during hospital stay and high PaCO2 on PICU admission were risk factors of mortality. CONCLUSIONS: ARDS has a high mortality rate in PICU, especially in those with extra-pulmonary diseases. In addition to aggressive medical management of comorbidity, lung protection and avoidance of discharge against medical advice will decrease the mortality.
BACKGROUND:Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) represents a devastating complication observed in critical care medicine. The purpose of this study is to investigate the epidemiological aspects of ALI/ARDS in pediatric intensive care unit (PICU) and risk factors of mortality. METHODS:Patients with ALI/ARDS in PICU of Beijing Children's Hospital, a tertiary medical center from November 1, 2005 to October 31, 2006 were included in this prospective study. We identified the risk factors for underlying diseases and mortality during a 3-month followup using multivariate logistic regression analysis. RESULTS: In 562 critically illpatients admitted to PICU of Beijing Children's Hospital, there were 15 ALI-non ARDS patients and 29 ARDS patients, resulting in an incidence of 7.8% (44/562). The mortality rate of ARDS was 24.1% (7/29) and that of ALI/ARDS was 18.2% (8/44). At a 3-month follow-up, 12 patients died after being discharged from PICU and the total mortality rate was 45.5% (20/44). ALI/ARDS patients with pulmonary disease had better outcomes than those with extra-pulmonary involvements (P<0.05). Discharge against medical advice, low PaO(2)/FiO(2) during hospital stay and high PaCO2 on PICU admission were risk factors of mortality. CONCLUSIONS: ARDS has a high mortality rate in PICU, especially in those with extra-pulmonary diseases. In addition to aggressive medical management of comorbidity, lung protection and avoidance of discharge against medical advice will decrease the mortality.
Authors: G Paret; T Ziv; A Augarten; A Barzilai; R Ben-Abraham; A Vardi; Y Manisterski; Z Barzilay Journal: Isr Med Assoc J Date: 1999-11 Impact factor: 0.892
Authors: G R Bernard; A Artigas; K L Brigham; J Carlet; K Falke; L Hudson; M Lamy; J R LeGall; A Morris; R Spragg Journal: Intensive Care Med Date: 1994 Impact factor: 17.440
Authors: Adrienne G Randolph; Kathleen L Meert; Mary E O'Neil; James H Hanson; Peter M Luckett; John H Arnold; Rainer G Gedeit; Peter N Cox; Joan S Roberts; Shekhar T Venkataraman; Peter W Forbes; Ira M Cheifetz Journal: Am J Respir Crit Care Med Date: 2003-02-25 Impact factor: 21.405
Authors: Gordon D Rubenfeld; Ellen Caldwell; Eve Peabody; Jim Weaver; Diane P Martin; Margaret Neff; Eric J Stern; Leonard D Hudson Journal: N Engl J Med Date: 2005-10-20 Impact factor: 91.245
Authors: James M O'Brien; Gary S Phillips; Naeem A Ali; Maria Lucarelli; Clay B Marsh; Stanley Lemeshow Journal: Crit Care Med Date: 2006-03 Impact factor: 7.598
Authors: Simon Erickson; Andreas Schibler; Andrew Numa; Gabrielle Nuthall; Michael Yung; Elaine Pascoe; Barry Wilkins Journal: Pediatr Crit Care Med Date: 2007-07 Impact factor: 3.624
Authors: M Bruijn; E M Jansen; T Klapwijk; J H van der Lee; R R van Rijn; J B M van Woensel; A P Bos Journal: Eur J Pediatr Date: 2013-05-03 Impact factor: 3.183