Acute respiratory distress syndrome in pediatric intensive care unit

Abstract

Objective: To report causes, clinical feature and outcome of children with Acute Respiratory Distress Syndrome (ARDS).

Methods: The case records of children admitted with ARDS from June 2003 to June 2006 were retrospectively reviewed and the data collected was analyzed.

Results: A total of 17 children were diagnosed as ARDS during study period giving an incidence of 22.7/1,000 admissions. The mean (SD) age was 74.5 (56.32) mo [range 6-144 mo]. Primary lung pathology contributed to a (53%) cases of ARDS while the rest (47%) had non pulmonary causes. There was not any significant different in mortality between these two groups. Similarly when infections and non infections conditions were considered separately there was no difference in survival. All children were ventilated using Pressure Controlled Ventilation. The mean (SD) duration of ventilation was 5.0 days [range 1-10 days]. The maximum PEEP (SD) used during the course of ventilation was 10 (3.37) cm H2O [range 7-18], while the maximum PIP (SD) used was 31 (3.75) cm H2O (range 25-36). The overall mortality was 70%; highest in children less than 2 years of age. Majority of the children had shock as the most common comorbid factor and had a high mortality (73.3%).

Conclusion: The high incidence and mortality of ARDS and the presence of a large proportion of potentially preventable accidents and poisoning cases in the study group underline the need for health education measures addressing preventive strategies among the rural population.