All issues > Volume 48(6); 2005

Original Article

Korean J Pediatr. 2005;48(6):599-605. Published online June 15, 2005.

Clinical Outcome and Prognostic Factors of Acute Respiratory Distress Syndrome in Children

Jung-Min JM Ko¹, Eun-Ju EJ Ha¹, Eun-Hee EH Lee¹, So-Youn SY Lee¹, Hyo-Bin HB Kim¹, Soo-Jong SJ Hong¹, Seong-Jong SJ Park¹

¹Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea

Correspondence Seong-Jong SJ Park ,Email: drpsj@amc.seoul.kr

Abstract

Purpose
: The purpose of this study was to examine the causes, clinical courses and outcomes in children with acute respiratory distress syndrome(ARDS), and evaluate the physiologic variables as prognostic factors in the patients.
Methods
: Retrograde medical chart review was carried out in 24 patients who were diagnosed with ARDS at the pediatric intensive care unit(PICU) during 20-month period.
Results
: The incidence of ARDS among all PICU admission was 3.7 percent and the mortality rate was 37.5 percent, which was 14.8 percent of overall deaths in PICU. The most common causes of ARDS were pneumonia and sepsis. We found significant differences between survivors and non- survivors in PaO2/FiO2 ratio(P/F ratio), alveolar arterial oxygen gradient and oxygenation index(OI) on the second day from the onset of ARDS. Therapies for ARDS such as high frequency oscillator ventilation(HFOV), recruitment maneuver and low dose corticosteroid improved the P/F ratio and OI, especially in survivors.
Conclusion
: The mortality rate of children with ARDS was 37.5 percent; an important cause of death in PICU. HFOV, recruitment maneuver and low dose corticosteroid seemed to be effective in pediatric ARDS. The P/F ratio, alveolar arterial oxygen gradient and OI on the second day from the onset of ARDS may be useful as prognostic factors.

Keywords :Acute respiratory distress syndrome , Clinical outcome , Prognostic factor