Geyik Mehmet, Konca Çapan, Tekin Mehmet
Department of Pediatrics, Adıyaman University Faculty of Medicine, Adıyaman, Turkey.
Department of Pediatrics, Adıyaman University Faculty of Medicine, Adıyaman, Turkey; Division of Pediatric Intensive Care, Department of Pediatrics, Adıyaman University Faculty of Medicine, Adıyaman, Turkey.
Turk Arch Pediatr. 2023 May;58(3):302-307. doi: 10.5152/TurkArchPediatr.2023.22196.
We aimed to evaluate the clinical, demographic, and laboratory characteristics of the patients followed up with pediatric acute respiratory distress syndrome in our pediatric intensive care unit and to determine the factors that have an effect on the outcomes.
The medical records of 40 patients with acute respiratory distress syndrome who were followed up on mechanical ventilators in the pediatric intensive care unit of Adıyaman University were retrospectively scanned. From the medical records, the demographic data, clinical features, and laboratory characteristics were recorded.
Eighteen of the patients were female and 22 were male. The mean age was 45.25 ± 56.63 months. A total of 27 (67.5%) of the patients were classified as pulmonary and 13 (32.5%) as extrapulmonary acute respiratory distress syndrome. Sixteen (40%) patients were followed in pressure-controlled mode only, 2 (5%) patients in volume-controlled mode only, and 22 (55%) patients in alternate modes. A total of 17 (42.5%) patients died. The median pediatric index of mortality, pediatric index of mortality-II, pediatric risk of mortality, and pediatric logistic organ dysfunction score values of the surviving patients were significantly lower than the dead patients. Median aspartate aminotransferase (P = .003) and lactate dehydrogenase (P = .008) values were found to be significantly higher in patients who died, while median pH values (P = .049) were found to be lower. The median length of stay in pediatric intensive care unit and duration of mechanical ventilators were significantly shorter in patients who died. Also, the median pediatric index of mortality, pediatric index of mortality-II, pediatric risk of mortality, and pediatric logistic organ dysfunction values of pulmonary acute respiratory distress syndrome patients were significantly lower than those of extrapulmonary acute respiratory distress syndrome patients.
Despite advances in follow-up and management, mortality due to acute respiratory distress syndrome is still high. Mechanical ventilator duration, length of stay in pediatric intensive care unit, some mechanical ventilator parameters, mortality scores, and laboratory tests were associated with mortality. Alternatively, mechanical ventilator applications may reduce mortality rates.
我们旨在评估在我院儿科重症监护病房接受小儿急性呼吸窘迫综合征治疗的患者的临床、人口统计学和实验室特征，并确定影响预后的因素。
回顾性查阅了阿迪亚曼大学儿科重症监护病房40例接受机械通气治疗的急性呼吸窘迫综合征患者的病历。从病历中记录人口统计学数据、临床特征和实验室特征。
18例患者为女性，22例为男性。平均年龄为45.25±56.63个月。共有27例（67.5%）患者被归类为肺源性急性呼吸窘迫综合征，13例（32.5%）为肺外急性呼吸窘迫综合征。16例（40%）患者仅采用压力控制模式，2例（5%）患者仅采用容量控制模式，22例（55%）患者采用交替模式。共有17例（42.5%）患者死亡。存活患者的小儿死亡率指数、小儿死亡率指数-II、小儿死亡风险和小儿逻辑器官功能障碍评分值显著低于死亡患者。死亡患者的天冬氨酸转氨酶（P = 0.003）和乳酸脱氢酶（P = 0.008）中位数显著更高，而pH值中位数（P = 0.049）更低。死亡患者在儿科重症监护病房的中位住院时间和机械通气时间显著更短。此外，肺源性急性呼吸窘迫综合征患者的小儿死亡率指数、小儿死亡率指数-II、小儿死亡风险和小儿逻辑器官功能障碍值中位数显著低于肺外急性呼吸窘迫综合征患者。
尽管在随访和管理方面取得了进展，但急性呼吸窘迫综合征导致的死亡率仍然很高。机械通气时间、在儿科重症监护病房的住院时间、一些机械通气参数、死亡率评分和实验室检查与死亡率相关。另外，机械通气应用可能降低死亡率。
