Department of Pediatrics, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India.
Indian J Pediatr. 2009 Oct;76(10):1013-6. doi: 10.1007/s12098-009-0215-x. Epub 2009 Nov 12.
To report causes, clinical feature and outcome of children with Acute Respiratory Distress Syndrome (ARDS).
The case records of children admitted with ARDS from June 2003 to June 2006 were retrospectively reviewed and the data collected was analyzed.
A total of 17 children were diagnosed as ARDS during study period giving an incidence of 22.7/1,000 admissions. The mean (SD) age was 74.5 (56.32) mo [range 6-144 mo]. Primary lung pathology contributed to a (53%) cases of ARDS while the rest (47%) had non pulmonary causes. There was not any significant different in mortality between these two groups. Similarly when infections and non infections conditions were considered separately there was no difference in survival. All children were ventilated using Pressure Controlled Ventilation. The mean (SD) duration of ventilation was 5.0 days [range 1-10 days]. The maximum PEEP (SD) used during the course of ventilation was 10 (3.37) cm H2O [range 7-18], while the maximum PIP (SD) used was 31 (3.75) cm H2O (range 25-36). The overall mortality was 70%; highest in children less than 2 years of age. Majority of the children had shock as the most common comorbid factor and had a high mortality (73.3%).
The high incidence and mortality of ARDS and the presence of a large proportion of potentially preventable accidents and poisoning cases in the study group underline the need for health education measures addressing preventive strategies among the rural population.
报告儿童急性呼吸窘迫综合征（ARDS）的病因、临床特征和转归。
回顾性分析 2003 年 6 月至 2006 年 6 月期间因 ARDS 住院的儿童病例记录，并对收集的数据进行分析。
研究期间共诊断 17 例 ARDS，发病率为 22.7/1000 例。平均（SD）年龄为 74.5（56.32）月[范围 6-144 月]。原发性肺部病变导致 ARDS 的占（53%）例，其余（47%）为非肺部原因。两组死亡率无显著差异。同样，当分别考虑感染和非感染情况时，存活率也没有差异。所有患儿均采用压力控制通气进行通气。通气的平均（SD）持续时间为 5.0 天[范围 1-10 天]。在通气过程中使用的最大 PEEP（SD）为 10（3.37）cm H2O[范围 7-18]，而使用的最大 PIP（SD）为 31（3.75）cm H2O[范围 25-36]。总的死亡率为 70%；2 岁以下儿童死亡率最高。大多数患儿存在休克，是最常见的合并症，死亡率较高（73.3%）。
ARDS 的发病率和死亡率高，且研究组中存在大量潜在可预防的事故和中毒病例，这突出表明需要对农村人口采取健康教育措施，制定预防策略。
