Pediatric Acute Lung Injury Epidemiology and Natural History Study

Abstract

This is the largest study to estimate prospectively the pediatric population-based acute respiratory distress syndrome incidence and the first incidence study performed during the routine application of lung protective ventilation in children. Our findings support a lower acute respiratory distress syndrome incidence and mortality than those reported for adults. PaO2/FIO2 ratios at acute respiratory distress syndrome onset and at 24 hrs after onset were helpful in defining groups at greater risk of dying (clinical trials registered with http://www.clinicaltrials.gov; NCT 01142544).

Mechanical Ventilation Strategies in Children With Acute Lung Injury

“…However, in the PALIVE study, 25% of patients on invasive mechanical ventilation were ventilated with expiratory tidal volumes greater than 10 mL/ kg (14). In a recently published study (16), children with ARDS were ventilated with a mean tidal volume of 7.6 ± 1.8 mL/kg, close to the stated practice in this survey. However, 10% of the children reported in that study were ventilated with tidal volumes greater than 9.9 mL/ kg (16).…”

“…In a recently published study (16), children with ARDS were ventilated with a mean tidal volume of 7.6 ± 1.8 mL/kg, close to the stated practice in this survey. However, 10% of the children reported in that study were ventilated with tidal volumes greater than 9.9 mL/ kg (16). Similarly, most pediatric intensivists reported considering alternative ventilation modes when reaching a PIP greater than 35 cm H 2 O.…”

“…There was no statistically significant difference between the three scenarios. The median (interquartile range) maximal PEEP used to obtain minimal So 2 was 14.5 cm H 2 O (12, 16) for scenario 1; 12 cm H 2 O (10, 15) for scenario 2; and 14 cm H 2 O (12,16) for scenario 3 (p = 0.06). Finally, the median (interquartile range) maximal acceptable PIP before considering another ventilation mode was 35 cm H 2 O (30-35) for all three scenarios (p = NS; Table 2).…”

Hambatan Implementasi Surviving Sepsis Campaign Guidelines 2012 pada Pasien Anak di Rumah Sakit Rujukan Tersier

“…Syndrome (ARDS) 30-40% disebabkan oleh sepsis dengan mortalitas sebesar 26-32% (10,11 menyebabkan mortalitas pasien gagal nafas pada penelitian ini lebih tinggi dibandingkan penelitian sebelumnya (10,11).…”

Risk factors for the development of acute respiratory distress syndrome: a case-control study

“…A pesar de la diversidad de criterios diagnósticos utilizados en el pasado y las distintas metodologías de investigación del SDRA, se estima una incidencia en niños de 1.5-80 casos por 100.000 habitantes; llegando a ser reportado en algunos estudios epidemiológicos una prevalencia de 0.86% al 7.8% de las admisiones en cuidados intensivos y del 5% al 20.5% en pacientes con ventilación mecánica, con (2,3) tasas de mortalidad entre 14% y 61% .…”