Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
Department of Anesthesiology and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Thorax. 2023 Nov;78(11):1135-1137. doi: 10.1136/thorax-2022-219961. Epub 2023 May 24.
Excess mortality risk imparted by acute respiratory failure in children is unknown. We determined excess mortality risk associated with mechanically ventilated acute respiratory failure in pediatric sepsis. Novel ICD10-based algorithms were derived and validated to identify a surrogate for acute respiratory distress syndrome to calculate excess mortality risk. Algorithm-identified ARDS was identified with specificity of 96.7% (CI 93.0 - 98.9) and sensitivity of 70.5% (CI 44.0 - 89.7). Excess risk of mortality for ARDS was 24.4% (CI 22.9 - 26.2). Development of ARDS requiring mechanical ventilation imparts modest excess risk of mortality in septic children.
儿童急性呼吸衰竭所带来的超额死亡风险尚不清楚。我们确定了机械通气治疗儿童脓毒症急性呼吸衰竭相关的超额死亡风险。我们制定并验证了基于 ICD10 的新算法，以确定急性呼吸窘迫综合征的替代指标，从而计算超额死亡风险。算法确定的 ARDS 特异性为 96.7%（93.0-98.9），敏感性为 70.5%（44.0-89.7）。ARDS 的超额死亡风险为 24.4%（22.9-26.2）。需要机械通气治疗的 ARDS 的发生给脓毒症患儿带来了适度的超额死亡风险。
