| A Clinical Study of the Acute Respiratory Distress Syndrome in Children |
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Taek Jin1, Dong Soo Kim1, Dong Hwan Shin2 |
1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea |
| 소아에서의 급성 호흡 곤란 증후군에 대한 임상적 고찰 |
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이택진1, 김동수1, 신동환2 |
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 병리학교실 |
Correspondence:
Dong Soo Kim, Email: dskim6634@yumc.yonsei.ac.kr
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| Abstract |
Purpose
: The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet.
Methods
: Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994.
Results
: A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, PaO2, PaCO2, PEEP, and PaO2/FiO2 on the seventh day after the onset of the ARDS.
Conclusion
: According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate. |
| Key Words:
Acute respiratory distress syndrome, Pediatric, Mortality, Respiratory failure |
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