2020, Number 4
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ABSTRACTIntroduction: The acute respiratory distress syndrome is a disease that evolves with severe hypoxemia, and it is not frequent in pediatric intensive care units, but it has high mortality rates.
Objective: To determine the relation between demographic and clinical variables with the mechanical ventilation and survival in children with acute respiratory distress syndrome.
Methods: Retrospective study in patients admitted in 15 pediatric intensive care units with diagnosis of acute respiratory distress syndrome. There was an assessment of the demographic variables, the clinical forms of this syndrome, the duration of mechanical ventilation and the survival rates. Qualitative variables were presented in absolute values and percentages, and were analyzed with the Pearson´s ji-square test and means comparison.
Results: 282 patients were recorded, 63.7% of them were under 6 years old, 54.4% were males and 51.1% were white. Pulmonary clinical forms prevailed (58,1%) and were correlated (p= 0,022) with the survival rates, and the mean of mechanical ventilation´s duration was of 10 days. There was relation (p= 0,000) between the duration of ventilation and mortality. It was recorded a total mortality of 40.78% (n= 115).
Conclusions: Acute respiratory distress syndrome has higher incidence in children under 6 years and in the pulmonary clinical forms that are related with a higher survival, which increases in the same way that mechanical ventilation´s amount of days do.
Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994 [acceso 12/01/2016];149(3 Pt 1):818-24. Disponible en: http://www.ouhsc.edu/surgery/selectedreadings/Pulmonary/7509706.pdf
De Luca D, Piastra M, Chidini G, Tissieres P, Calderini E, Essouri S, et al. The use of the Berlin definition for acute respiratory distress syndrome during infancy and early childhood: multicenter evaluation and expert consensus. Intensive Care Med. 2013 [acceso 22/06/2019];39 (12):2083-91. Disponible en: http://link.springer.com/article/10.1007/s00134-013-3110- x/fulltext.html?view=classic
Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatric critical care medicine. J Soc Critical Care Med and World Federat Pediatr Intensiv Critical Care. 2015;16(5):428-39. doi:10.1097/PCC.0000000000000350
Kesecioglu J, Beale R, Stwart TE, Findlay GP, Rouby JJ, Holzapfel L, et al. Exogenus natural surfactant for treatment of acute lung injury and the acute respiratory distress syndrome. Am J Respir Crit Care Med 2009 acceso 12/01/2016;180:989-94. Disponible en: http://www.atsjournals.org/doi/full/10.1164/rccm.2008 12-1955OC
Halbertsma FJJ, Vaneker M, van der Hoeven JG. Use of recruitment maneuvers during mechanical ventilation in pediatric and neonatal intensive care units in the Netherlands. Intensiv Care Med. 2007 [acceso 12/01/2016];33:1673-74. Disponible en: https://www.researchgate.net/profile/Feico_Halbertsma/publication/6396045_Use_of_recruitment_maneuvers_during_mechanical_ventilation_in_pediatric_and_neonatal_intensive_care_units_in_the_Netherlands/links/554c72580cf29f836c991c37.pdf#page=90
Wong JJ, Loh TF, Testoni D, Yeo JG, Mok YH, Lee JH. Epidemiology of pediatric acute respiratory distress syndrome in singapore: risk factors and predictive respiratory indices for mortality. Front Pediatr. 2014 [acceso 12/01/2016];2:78. Disponible en: https://www.researchgate.net/profile/Jan_Hau_Lee2/publication/26479.
Villar J, Ambros A, Soler JA, Martínez D, Ferrando C: Stratification and Outcome of Acute Respiratory Distress Syndrome (STANDARDS) Network. Age, PaO2/FiO2, and Plateau Pressure Score: A proposal for a simple outcome score in patients with the acute respiratory distress syndrome. Crit Care Med. 2016; 44:1361-1369.