Evaluation of Patients with Acute Respiratory Distress Syndrome Followed on Mechanical Ventilator in a Tertiary Pediatric Intensive Care and the Factors That May Be Associated with Death in These Patients.

objectiveWe aimed to evaluate the clinical, demographic, and laboratory characteristics of the patients followed up with pediatric acute respiratory distress syndrome in our pediatric intensive care unit and to determine the factors that have an effect on the outcomes. MATERIALS AND

methodsThe medical records of 40 patients with acute respiratory distress syndrome who were followed up on mechanical ventilators in the pediatric intensive care unit of Adıyaman University were retrospectively scanned. From the medical records, the demographic data, clinical features, and laboratory characteristics were recorded.

resultsEighteen of the patients were female and 22 were male. The mean age was 45.25 ± 56.63 months. A total of 27 (67.5%) of the patients were classified as pulmonary and 13 (32.5%) as extrapulmonary acute respiratory distress syndrome. Sixteen (40%) patients were followed in pressure-controlled mode only, 2 (5%) patients in volume-controlled mode only, and 22 (55%) patients in alternate modes. A total of 17 (42.5%) patients died. The median pediatric index of mortality, pediatric index of mortality-II, pediatric risk of mortality, and pediatric logistic organ dysfunction score values of the surviving patients were significantly lower than the dead patients. Median aspartate aminotransferase (P = .003) and lactate dehydrogenase (P = .008) values were found to be significantly higher in patients who died, while median pH values (P = .049) were found to be lower. The median length of stay in pediatric intensive care unit and duration of mechanical ventilators were significantly shorter in patients who died. Also, the median pediatric index of mortality, pediatric index of mortality-II, pediatric risk of mortality, and pediatric logistic organ dysfunction values of pulmonary acute respiratory distress syndrome patients were significantly lower than those of extrapulmonary acute respiratory distress syndrome patients.

conclusionDespite advances in follow-up and management, mortality due to acute respiratory distress syndrome is still high. Mechanical ventilator duration, length of stay in pediatric intensive care unit, some mechanical ventilator parameters, mortality scores, and laboratory tests were associated with mortality. Alternatively, mechanical ventilator applications may reduce mortality rates.