Author Of 1 Presentation
SEVERITY AND MORTALITY PREDICTORS OF PEDIATRICS ACUTE RESPIRATORY DISTRESS SYNDROME IN SINGLE TERTIARY HOSPITAL
Abstract
Background
Pediatric acute respiratory distress syndrome (PARDS) has been recognized as a burden for critically ill pediatric patients. Previously, the definitions of PARDS were referenced from adults. In 2015, the Pediatric Acute Lung Injury Consensus Conference (PALICC) developed new criteria which were specific for the pediatric group.
Objectives
To examine the incidence and the factors predicting the severity and mortality of ARDS according to PALICC definition in a single tertiary center in Thailand.
Methods
Children aged 1 month to 15 years with acute respiratory failure admitted to the Pediatric intensive care unit (PICU) in Songklanagarind Hospital from January 2013 to December 2016 were reviewed retrospectively.
Results
129 patients (7.4%) were diagnosed as PARDS using the PALICC definition whereas 97 patients (5.5%) by using Berlin definition. From PALICC definition; fifty-seven (44.2%) patients were mild, 35 (27.1%) were moderate, and 37 (28.1%) were severe. After multivariable analysis was performed, factors significantly associated with moderate to severe disease were PRISM III score (p =0.004), underlying oncologic/hematologic disorder (p=0.012), and serum albumin level (p=0.006). The 30-day all-cause mortality rate was 51.2% (66/129). The predictors of mortality were the PRISM III score (p=0.017), underlying oncologic/hematologic disorder (p=0.002), receiving systemic steroid (p=0.019), having airleak syndrome (p=0.008), and presenting with multiorgan dysfunction (p=0.003).
Conclusion
The incidence and mortality rate of PARDS in a developing country are high. The oncologic/hematologic comorbidity had a significant impact on severity and mortality.