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A Nationwide Clinical Study of Acute Respiratory Distress Syndrome in Children

Journal of the Korean Pediatric Society 1999;42(1):23-31.
Published online January 15, 1999.
A Nationwide Clinical Study of Acute Respiratory Distress Syndrome in Children
Soo Jung Choi1, Do Suck Jeong1, Jae Won Oh1, Ha Baik Lee1, Im Ju Kang2, Kwang Woo Kim3, Kyu Earn Kim4, Ki Bok Kim5, Young Ho Rah6, Kang Seo Park7, Byong Kwan Son8, Ki Young Lee4, Sang Il Lee9, Ji Tai Choung10, Young Mi Hong11
1Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
2Department of Pediatrics, College of Medicine, Taegu Fatima Hospital, Taegu, Korea
3Department of Pediatrics, College of Medicine, Handong University Sunlin Presbyterian Hospital, Pohang, Korea
4Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
4Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
5Department of Pediatrics, College of Medicine, Kwangju Christian Hospital, Kwangju, Korea
6Department of Pediatrics, College of Medicine, Kyung Hee University, Korea
7Department of Pediatrics, College of Medicine, Presbyterian Medical Center, Chonju, Korea
8Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
9Department of Pediatrics, College of Medicine, Sungkyunkwan University, Seoul, Korea
10Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
11Department of Pediatrics, College of Medicine, Ewha Womens University, Seoul, Korea
소아 급성 호흡곤란증후군에 대한 다기관 공동조사 : 1995년-1997년의 증례들
최수정1, 정도석1, 오재원1, 이하백1, 강임주2, 김광우3, 김규언4, 김기복5, 나영호6, 박강서7, 손병관8, 이기영4, 이상일9, 정지태10, 홍영미11
1한양대학교 의과대학 소아과학교실
2대구파티마병원 소아과
3포항선린병원 소아과
4연세대학교 의과대학 소아과학교실
4연세대학교 의과대학 소아과학교실
5광주기독병원 소아과
6경희대학교 의과대학 소아과학교실
7전주예수병원 소아과
8인하대학교 의과대학 소아과학교실
9성균관대학교 의과대학 소아과학교실
10고려대학교 의과대학 소아과학교실
11이화여자대학교 의과대학 소아과학교실
Abstract
Purpose
: Acute respiratory distress syndrome(ARDS) is the final course of acute lung injury. It results from various etiological origins and pathophysiologic mechanisms, and has a mortality rate of approximately 60-70%. Although the confirmative incidence of ARDS in children is yet unknown, the increasing incidence of ARDS has been reported in Korea. In the present study, we report ARDS diagnosed at the Clinic for Pediatric Allergy and Respiratory Disease in eleven medical centers nationwide.
Methods
: The study was conducted on 42 patients diagnosed with ARDS in Pediatric Allergy and Respiratory Clinics from January, 1995 to August, 1997. We analyzed the clinical course and treatment modalities of the 42 cases of ARDS retrospectively.
Results
: The total number of patients recruited was 42, including seventeen(40.4%) below 1-year-old. The mean age was 2.0¡¾2.3(mean¡¾standard deviation) years with a range of 2 months to 10 years, and there was no sex predominance(male/female : 27/15). Twenty-one cases(50.0%) occured during the spring(March, April and May). The major triggering factors of ARDS were viral pneumonia(59.5%) and bacterial pneumonia (19.1%). Mechanical ventilation was used in 37 cases(88.1%). Major complications included pneumothorax, DIC, and gastrointestinal bleeding. The mortality rate was 61.9% of which 16 case (61.5%) occurred before 2 years of age. Concldusion : We conducted this study to make a rapid diagnosis and appropriate treatment of ARDS in children, who have major risk factors, to reduce its mortality rate.
Key Words: Acute respiratory distress syndrome, Clinical observation, Mortality rate, Survey, Multicenter study


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