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A Clinical Study of the Acute Respiratory Distress Syndrome in Children

Journal of the Korean Pediatric Society 2003;46(1):42-50.
Published online January 15, 2003.
A Clinical Study of the Acute Respiratory Distress Syndrome in Children
Taek Jin1, Dong Soo Kim1, Dong Hwan Shin2
1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
소아에서의 급성 호흡 곤란 증후군에 대한 임상적 고찰
이택진1, 김동수1, 신동환2
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 병리학교실
Correspondence: 
Dong Soo Kim, Email: dskim6634@yumc.yonsei.ac.kr
Abstract
Purpose
: The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet.
Methods
: Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994.
Results
: A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, PaO2, PaCO2, PEEP, and PaO2/FiO2 on the seventh day after the onset of the ARDS.
Conclusion
: According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.
Key Words: Acute respiratory distress syndrome, Pediatric, Mortality, Respiratory failure


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