All issues > Volume 42(1); 1999

Original Article

J Korean Pediatr Soc. 1999;42(1):23-31. Published online January 15, 1999.

A Nationwide Clinical Study of Acute Respiratory Distress Syndrome in Children

Soo Jung SJ Choi¹, Do Suck DS Jeong¹, Jae Won JW Oh¹, Ha Baik HB Lee¹, Im Ju IJ Kang², Kwang Woo KW Kim³, Kyu Earn KE Kim⁴, Ki Bok KB Kim⁵, Young Ho YH Rah⁶, Kang Seo KS Park⁷, Byong Kwan BK Son⁸, Ki Young KY Lee⁴, Sang Il SI Lee⁹, Ji Tai JT Choung¹⁰, Young Mi YM 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

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.

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