Evidence map›Paper›PMID 32271186›Full record

ArticleCritical care medicine2020

Predicting Mortality in Children With Pediatric Acute Respiratory Distress Syndrome: A Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Study.

Nadir Yehya, Michael O Harhay, Margaret J Klein, Steven L Shein, Byron E Piñeres-Olave, Ledys Izquierdo, Anil Sapru, Guillaume Emeriaud, Philip C Spinella, Heidi R Flori and 14 more

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In one paragraph

Article in Critical care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2023
    Review
  7. Article
  8. Epidemiology of Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit: Single-center Experience.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022
    Article
  9. Article
  10. Article
  11. Observational
  12. Article
  13. Article
  14. Article
  15. Review
  16. Observational
  17. Review
  18. Article
  19. Observational
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Nadir YehyaDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA.
Michael O HarhayDepartment of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
Margaret J KleinDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles and University of Southern California, Los Angeles, CA.
Steven L SheinDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, Rainbow Babies and Children's Hospital and Case Western Reserve University, Cleveland, OH.
Byron E Piñeres-OlavePediatric Critical Care Unit, Hospital Pablo Tobón Uribe, Medellín, Colombia.
Ledys IzquierdoDepartment of Pediatrics, Hospital Militar Central, Bogotá, Colombia.
Anil SapruDepartment of Pediatrics, Division of Critical Care, University of California Los Angeles Mattel Children's Hospital, Los Angeles, CA.
Guillaume EmeriaudDepartment of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine and Université de Montréal, Montreal, QC, Canada.
Philip C SpinellaDepartment of Pediatrics, Division of Critical Care, Washington University in St. Louis, St. Louis, MO.
Heidi R FloriDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, Mott Children's Hospital and University of Michigan, Ann Arbor, MI.
Mary K DahmerDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, Mott Children's Hospital and University of Michigan, Ann Arbor, MI.
Aline B MadduxDepartment of Pediatrics, Children's Hospital Colorado and University of Colorado, Aurora, CO.
Yolanda M Lopez-FernandezDepartment of Pediatrics, Cruces University Hospital, Bizkaia, Basque Country, Spain.
Bereketeab HaileselassieDepartment of Pediatrics, Division of Pediatric Critical Care, Stanford University, Palo Alto, CA.
Deyin Doreen HsingDepartment of Pediatrics, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY.
Ranjit S ChimaDepartment of Pediatrics, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH.
Amanda B HassingerDepartment of Pediatrics, Division of Pediatric Critical Care, Oishei Children's Hospital and University of Buffalo, Buffalo, NY.
Stacey L ValentineDepartment of Pediatrics, Division of Pediatric Critical Care, University of Massachusetts Children's Medical Center, Worcester, MA.
Courtney M RowanDepartment of Pediatrics, Division of Critical Care, Riley Hospital for Children and Indiana University, Indianapolis, IN.
Martin C J KneyberDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, Beatrix Children's Hospital and University of Groningen, Groningen, The Netherlands.
Lincoln S SmithDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, Seattle Children's Hospital and University of Washington, Seattle, WA.
Robinder G KhemaniDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles and University of Southern California, Los Angeles, CA.
Neal J ThomasDepartment of Pediatrics and Public Health Science, Division of Pediatric Critical Care Medicine, Penn State Hershey Children's Hospital, Hershey, PA.
Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology (PARDIE) V1 Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network

Funding

Disparities in COVID Disease Severity and Outcomes in New York CityUL1TR002384 · NCATS · WEILL MEDICAL COLL OF CORNELL UNIV · PI JULIANNE L IMPERATO-MCGINLEY · 2017 to 2026
$86.2M
Southern California Clinical and Translational Science InstituteUL1TR001855 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Thomas A Buchanan, Michele D. Kipke · 2016 to 2026
$81.3M
Clinical and Translational Science CenterUL1TR000457 · NCATS · WEILL MEDICAL COLL OF CORNELL UNIV · PI IMPERATO-MCGINLEY, JULIANNE L · 2012 to 2016
$46.0M
Pediatric Critical Care Scientist Development ProgramK12HD047349 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI HEATHER T. KEENAN, Kevin M Watt · 2004 to 2026
$17.0M
Linking Endotypes and Outcomes in Pediatric Acute Respiratory Distress SyndromeR01HL148054 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI YEHYA, NADIR · 2019 to 2023
$4.1M
1/2 PROSpect: Prone and Oscillation Pediatric Clinical Trial (CCC)UG3HL141736 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI CHEIFETZ, IRA M, CURLEY, MARTHA AQ · 2018 to 2018
$1.7M
Functional Outcomes after Prolonged Mechanical Ventilation in ChildrenK23HD096018 · NICHD · UNIVERSITY OF COLORADO DENVER · PI MADDUX, ALINE BERNARD · 2019 to 2023
$807k
Improving the measurement and analysis of long-term, patient-centered outcomes following acute respiratory failureR00HL141678 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI HARHAY, MICHAEL OSCAR · 2020 to 2022
$747k
Clinical and Proteomic Characterization of Nucleosomes in Pediatric Acute Respiratory Distress SyndromeK23HL136688 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI YEHYA, NADIR · 2017 to 2020
$694k
NCATS NIH HHS UL1 TR000457NCATS NIH HHS UL1 TR001855NCATS NIH HHS UL1 TR002384NHLBI NIH HHS K23 HL136688NHLBI NIH HHS L40 HL134039NHLBI NIH HHS R00 HL141678NHLBI NIH HHS R01 HL148054NHLBI NIH HHS UG3 HL141736NICHD NIH HHS K12 HD047349NICHD NIH HHS K23 HD096018
6 · The paper itself

Abstract

objectivesPediatric acute respiratory distress syndrome is heterogeneous, with a paucity of risk stratification tools to assist with trial design. We aimed to develop and validate mortality prediction models for patients with pediatric acute respiratory distress syndrome.

designLeveraging additional data collection from a preplanned ancillary study (Version 1) of the multinational Pediatric Acute Respiratory Distress syndrome Incidence and Epidemiology study, we identified predictors of mortality. Separate models were built for the entire Version 1 cohort, for the cohort excluding neurologic deaths, for intubated subjects, and for intubated subjects excluding neurologic deaths. Models were externally validated in a cohort of intubated pediatric acute respiratory distress syndrome patients from the Children's Hospital of Philadelphia.

settingThe derivation cohort represented 100 centers worldwide; the validation cohort was from Children's Hospital of Philadelphia. PATIENTS: There were 624 and 640 subjects in the derivation and validation cohorts, respectively.

interventionsNone. MEASUREMENTS AND MAIN

resultsThe model for the full cohort included immunocompromised status, Pediatric Logistic Organ Dysfunction 2 score, day 0 vasopressor-inotrope score and fluid balance, and PaO2/FIO2 6 hours after pediatric acute respiratory distress syndrome onset. This model had good discrimination (area under the receiver operating characteristic curve 0.82), calibration, and internal validation. Models excluding neurologic deaths, for intubated subjects, and for intubated subjects excluding neurologic deaths also demonstrated good discrimination (all area under the receiver operating characteristic curve ≥ 0.84) and calibration. In the validation cohort, models for intubated pediatric acute respiratory distress syndrome (including and excluding neurologic deaths) had excellent discrimination (both area under the receiver operating characteristic curve ≥ 0.85), but poor calibration. After revision, the model for all intubated subjects remained miscalibrated, whereas the model excluding neurologic deaths showed perfect calibration. Mortality models also stratified ventilator-free days at 28 days in both derivation and validation cohorts.

conclusionsWe describe predictive models for mortality in pediatric acute respiratory distress syndrome using readily available variables from day 0 of pediatric acute respiratory distress syndrome which outperform severity of illness scores and which demonstrate utility for composite outcomes such as ventilator-free days. Models can assist with risk stratification for clinical trials.

Indexed as

AdolescentChildChild, PreschoolHumansImmunocompromised HostIncidenceIntensive Care Units, PediatricIntubation, IntratrachealPrognosisRespiration, ArtificialRespiratory Distress SyndromeROC CurveSensitivity and SpecificitySeverity of Illness IndexWater-Electrolyte Balance

Identifiers

PMID32271186
PMCPMC7237024

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.