A Nationwide Clinical Study of Acute Respiratory Distress Syndrome in  Children

Choi, Soo Jung; Jeong, Do Suck; Oh, Jae Won; Lee, Ha Baik; Kang, Im Ju; Kim, Kwang Woo; Kim, Kyu Earn; Kim, Ki Bok; Rah, Young Ho; Park, Kang Seo; Son, Byong Kwan; Lee, Ki Young; Lee, Sang Il; Choung, Ji Tai; Hong, Young Mi

Original Article

Journal of the Korean Pediatric Society 1999;42(1):23-31.
Published online January 15, 1999.

A Nationwide Clinical Study of Acute Respiratory Distress Syndrome in Children

Soo Jung Choi¹, Do Suck Jeong¹, Jae Won Oh¹, Ha Baik Lee¹, Im Ju Kang², Kwang Woo Kim³, Kyu Earn Kim⁴, Ki Bok Kim⁵, Young Ho Rah⁶, Kang Seo Park⁷, Byong Kwan Son⁸, Ki Young Lee⁴, Sang Il Lee⁹, Ji Tai Choung¹⁰, Young Mi Hong¹¹

¹Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
²Department of Pediatrics, College of Medicine, Taegu Fatima Hospital, Taegu, Korea
³Department of Pediatrics, College of Medicine, Handong University Sunlin Presbyterian Hospital, Pohang, Korea
⁴Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
⁴Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
⁵Department of Pediatrics, College of Medicine, Kwangju Christian Hospital, Kwangju, Korea
⁶Department of Pediatrics, College of Medicine, Kyung Hee University, Korea
⁷Department of Pediatrics, College of Medicine, Presbyterian Medical Center, Chonju, Korea
⁸Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
⁹Department of Pediatrics, College of Medicine, Sungkyunkwan University, Seoul, Korea
¹⁰Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
¹¹Department of Pediatrics, College of Medicine, Ewha Womens University, Seoul, Korea

소아 급성 호흡곤란증후군에 대한 다기관 공동조사 : 1995년-1997년의 증례들

최수정^¹^, 정도석^¹^, 오재원^¹^, 이하백^¹^, 강임주^²^, 김광우^³^, 김규언^⁴^, 김기복^⁵^, 나영호^⁶^, 박강서^⁷^, 손병관^⁸^, 이기영^⁴^, 이상일^⁹^, 정지태^¹⁰^, 홍영미^¹¹

^¹한양대학교 의과대학 소아과학교실
^²대구파티마병원 소아과
^³포항선린병원 소아과
^⁴연세대학교 의과대학 소아과학교실
^⁴연세대학교 의과대학 소아과학교실
^⁵광주기독병원 소아과
^⁶경희대학교 의과대학 소아과학교실
^⁷전주예수병원 소아과
^⁸인하대학교 의과대학 소아과학교실
^⁹성균관대학교 의과대학 소아과학교실
^¹⁰고려대학교 의과대학 소아과학교실
^¹¹이화여자대학교 의과대학 소아과학교실

Abstract

Purpose
: Acute respiratory distress syndrome(ARDS) is the final course of acute lung injury. It results from various etiological origins and pathophysiologic mechanisms, and has a mortality rate of approximately 60-70%. Although the confirmative incidence of ARDS in children is yet unknown, the increasing incidence of ARDS has been reported in Korea. In the present study, we report ARDS diagnosed at the Clinic for Pediatric Allergy and Respiratory Disease in eleven medical centers nationwide.
Methods
: The study was conducted on 42 patients diagnosed with ARDS in Pediatric Allergy and Respiratory Clinics from January, 1995 to August, 1997. We analyzed the clinical course and treatment modalities of the 42 cases of ARDS retrospectively.
Results
: The total number of patients recruited was 42, including seventeen(40.4%) below 1-year-old. The mean age was 2.0¡¾2.3(mean¡¾standard deviation) years with a range of 2 months to 10 years, and there was no sex predominance(male/female : 27/15). Twenty-one cases(50.0%) occured during the spring(March, April and May). The major triggering factors of ARDS were viral pneumonia(59.5%) and bacterial pneumonia (19.1%). Mechanical ventilation was used in 37 cases(88.1%). Major complications included pneumothorax, DIC, and gastrointestinal bleeding. The mortality rate was 61.9% of which 16 case (61.5%) occurred before 2 years of age. Concldusion : We conducted this study to make a rapid diagnosis and appropriate treatment of ARDS in children, who have major risk factors, to reduce its mortality rate.

Key Words: Acute respiratory distress syndrome, Clinical observation, Mortality rate, Survey, Multicenter study