Korean Journal of Pediatrics 2004;47(5):555-560.
Published online May 15, 2004.
Cause and Prognosis of Pediatric Acute Respiratory Failure by Intrapulmonary Lesion
Hye-Young Lee, Ji-Suk Park, Hee-Ra Choi, Ji-Hyun Seo, Jeum-Su Kim, Jae-Young Lim, Myoung-Bum Choi, Chan-Hoo Park, Hyang-Ok Woo, Hee-Shang Youn
Department of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
폐 내 병변으로 인한 소아 급성 호흡부전의 원인 질환과 예후
이혜영, 박지숙, 최희라, 서지현, 김정수, 임재영, 최명범, 박찬후, 우향옥, 윤희상
경상대학교 의과대학 소아과학교실
Correspondence: 
Hyang-Ok Woo, Email: howoo@gshp.gsnu.ac.kr
Abstract
Purpose
: Respiratory failure arises from derangements in pulmonary gas exchange. The causes may be classified as due to either lung disease or respiratory pump dysfunction. Problems with lung mechanics is an important cause of acute respiratory failure in children clinically. The aims of this study were to survey the cause and prognosis of children diagnosed with acute respiratory failure by intrapulmonary lesion.
Methods
: We performed a retrospective study of 52 children(M : F=31 : 21) diagnosed with acute respiratory failure by intrapulmonary lesion in Gyeongsang National University Hospital from January, 1989 to July, 2003. The age distribution was from 0.1 to 12 years old(2.6?.3 yr).
Results
: The causes of acute respiratory failure were bronchiolitis and infectious pneumonia(24 cases, 46.1%), acute respiratory distress syndrome(14 cases, 26.9%), near drowning(seven cases, 13.5 %), aspiration pneumonia(three cases, 5.8%), sepsis with intrapulmonary lesion(three cases, 5.8%) and croup(one case, 1.9%). The underlying diseases of acute respiratory distress syndrome were aspiration pneumonia(four cases, 28.6%), near drowning(three cases, 21.4%), pneumonia(three cases, 21.4%), sepsis with pneumonia(two cases, 14.3%), and shock(two cases, 14.3%). The survival rate of all subjects was 67.3%. The survival rate of underlying diseases were : 83.3% in cases of bronchiolitis and infectious pneumonia, 57.1% in near drowning, 42.8% in acute respiratory distress syndrome, 33.3% in sepsis, and 100% in aspiration pneumonia and croup.
Conclusion
: The major cause of acute respiratory failure by intrapulmonary lesion in children was respiratory infection. And acute respiratory distress syndrome and sepsis with intrapulmonary lesion had relatively poor prognoses, thus active and prompt intervention is important in these conditions.
Key Words: Acute respiratory failure, Acute respiratory distress syndrome, Cause, Prognosis


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