Evaluation of patients with acute respiratory distress syndrome (ARDS)
followed on mechanical ventilator in a tertiary pediatric intensive care
and the factors that may be associated with death in these patients.
Abstract
Objective: To evaluate the clinical, demographic and laboratory
characteristics of the patients followed up with the diagnosis of acute
respiratory distress syndrome (ARDS) in our pediatric intensive care
unit (PICU) and to determine the factors that have an effect on the
outcomes. Methods: The files of 40 patients with ARDS who were followed
up on mechanical ventilators (MV) in PICU of XXXX University between
2013 and 2018 were retrospectively scanned. Results: Eighteen of the
patients were female and 22 were male. The mean age was 45.25±56.63
months. 27 (67.5%) of the patients were classified as pulmonary and 13
(32.5%) as extrapulmonary ARDS. Sixteen (40%) patients were followed
in pressure-controlled mode only, 2 (5%) patients in volume-controlled
mode only, and 22 (55%) patients in alternately modes. The median value
of the length of stay (LOS) in PICU was 17.5 days. The median duration
of the stay on MV was 276.5 hours. 17 (42.5%) patients died. The median
PIM, PIM-II, PRISM and PELOD scores values of the surviving patients
were significantly lower than died patients. Median AST (p=0.003) and
LDH (p= 0.008) values were found to be significantly higher in patients
who died, while median pH values (p=0.049) were found to be lower. The
median LOS in PICU and duration of MV were significantly shorter in
patients who died. Also, the median PIM, PIM-II, PRISM and PELOD values
of pulmonary ARDS patients were significantly lower than those of
extrapulmonary ARDS patients. Conclusion: Despite advances in follow-up
and management, mortality due to ARDS is still high. MV duration, LOS in
PICU, some MV parameters, mortality scores and laboratory tests
associated with mortality. Alternately MV applications may reduce
mortality rates.