Valérie Boucher1, Clémence Mathy2, Jacques Lacroix3,4, Guillaume Émériaud3,4, Philippe Jouvet3,4, Sze Man Tse4,5. 1. Department of Family Medicine, University of Montréal, Montréal, Canada. 2. Department of Psychology, University of Bourgogne, Dijon, France. 3. Division of Pediatric Critical Care Medicine, CHU Sainte-Justine, Montréal, Canada. 4. Department of Pediatrics, University of Montréal, Montréal, Canada. 5. Division of Respiratory Medicine, CHU Sainte-Justine, Montréal, Canada.
Abstract
OBJECTIVES: While long-term sequelae of acute respiratory distress syndrome (ARDS) are well-documented in adults, few studies reported post-discharge respiratory complications in pediatric ARDS (PARDS) and none used the recent Pediatric Acute Lung Injury Consensus Conference (PALICC) diagnostic criteria. This study describes the respiratory symptoms, pulmonary function, and health resource use of PARDS survivors at 3 months post-discharge. DESIGN: Retrospective study. PATIENT SELECTION: Children less than 18 years admitted to the intensive care unit of Sainte-Justine University Health Center from 1st September 2015 to 1st July 2017, and meeting PALICC diagnostic criteria for PARDS. METHODS: We evaluated 38 of the 44 children with PARDS in the follow-up clinic at a mean (SD) of 3.4 (2.0) months post-discharge for respiratory symptoms, age-appropriate pulmonary function tests (spirometry or oscillometry, maximal respiratory pressures), and all-cause emergency department (ED) visits or rehospitalizations since discharge. RESULTS: Fourteen (36.8%) had abnormal respiratory symptoms (most commonly cough between respiratory infections and wheezing), 7 of whom (18.4%) presented new respiratory symptoms since PARDS diagnosis. A mild-to-moderate restrictive pattern was observed in 3 of 10 patients who performed spirometry and mildly decreased maximal inspiratory pressures were noted in 2 of 8 patients who performed these maneuvers. Nine (23.7%) patients consulted in the ED and 4 (10.5%) were rehospitalized post-discharge. CONCLUSIONS: Despite our cohort's limited sample size, our findings suggest that a significant proportion of PARDS survivors experience abnormal respiratory symptoms, pulmonary function deficits, and recurrent problems requiring medical attention. Larger, multicenter studies are required to identify risk factors associated with poor post-discharge outcomes among PARDS survivors.
OBJECTIVES: While long-term sequelae of acute respiratory distress syndrome (ARDS) are well-documented in adults, few studies reported post-discharge respiratory complications in pediatric ARDS (PARDS) and none used the recent Pediatric Acute Lung Injury Consensus Conference (PALICC) diagnostic criteria. This study describes the respiratory symptoms, pulmonary function, and health resource use of PARDS survivors at 3 months post-discharge. DESIGN: Retrospective study. PATIENT SELECTION: Children less than 18 years admitted to the intensive care unit of Sainte-Justine University Health Center from 1st September 2015 to 1st July 2017, and meeting PALICC diagnostic criteria for PARDS. METHODS: We evaluated 38 of the 44 children with PARDS in the follow-up clinic at a mean (SD) of 3.4 (2.0) months post-discharge for respiratory symptoms, age-appropriate pulmonary function tests (spirometry or oscillometry, maximal respiratory pressures), and all-cause emergency department (ED) visits or rehospitalizations since discharge. RESULTS: Fourteen (36.8%) had abnormal respiratory symptoms (most commonly cough between respiratory infections and wheezing), 7 of whom (18.4%) presented new respiratory symptoms since PARDS diagnosis. A mild-to-moderate restrictive pattern was observed in 3 of 10 patients who performed spirometry and mildly decreased maximal inspiratory pressures were noted in 2 of 8 patients who performed these maneuvers. Nine (23.7%) patients consulted in the ED and 4 (10.5%) were rehospitalized post-discharge. CONCLUSIONS: Despite our cohort's limited sample size, our findings suggest that a significant proportion of PARDS survivors experience abnormal respiratory symptoms, pulmonary function deficits, and recurrent problems requiring medical attention. Larger, multicenter studies are required to identify risk factors associated with poor post-discharge outcomes among PARDS survivors.
Authors: Aline B Maddux; Peter M Mourani; Russell Banks; Ron W Reeder; Murray M Pollack; Robert A Berg; Kathleen L Meert; Patrick S McQuillen; Andrew R Yates; Daniel A Notterman; John T Berger Journal: Respir Care Date: 2021-10 Impact factor: 2.339
Authors: Michelle Vo; Kristen Miller; Tellen D Bennett; Peter M Mourani; Jaime LaVelle; Todd C Carpenter; R Scott Watson; Laura L Pyle; Aline B Maddux Journal: Pediatr Pulmonol Date: 2022-04-26