Risk Factors Associated with Acute Respiratory Distress Syndrome in Pediatrics
DOI:
https://doi.org/10.70749/ijbr.v3i2.688Keywords:
Risk Factors Associated with ARDS in Pediatric PatientsAbstract
Background: Every expectant mother hopes for a healthy baby, yet complications during delivery can lead to severe conditions like acute respiratory distress syndrome (ARDS). This study aims to identify key risk factors associated with ARDS in pediatric patients. Methodology: A questionnaire was developed through a literature review to identify key ARDS risk factors in pediatrics. The questionnaire was verified by a panel of pediatric experts, and its reliability was tested (Cronbach’s alpha = 0.5). Results: Among the infants, 55% were male and 45% female. APGAR scores showed 36% had mild depression, 46% moderate, and 18% severe asphyxia. Mechanical ventilation was required for 40% of patients. Preterm births accounted for 67.13% of cases, while 64.3% were term and 8.4% late-term. C-section deliveries were common (65.03%), and 41% of patients had raised bilirubin levels. Only 20% were breastfed, while 58% required nasogastric tubes. Most patients (81.82%) were aged 1 day to 1 month. Hospital stays varied: 35% in days, 46% in weeks, and 19% in months. Advanced Cardiac Life Support was needed for 29%, and blood transfusions for 24%. Ventilator modes varied, with nasal cannula (45%) being the most used. PaO₂/FiO₂ ratios were normal in 29%, mild in 33%, moderate in 21%, and severe in 17%. Mortality was 24%. Conclusion: Preterm birth and mechanical ventilation were the major risk factors for pediatric ARDS. Sepsis, HIE II & III, pneumonia, metabolic disorders, and meconium aspiration were prevalent diagnoses.Surfactant therapy was associated with a 68% mortality rate, emphasizing its impact on lung maturity.
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Matthay, M. A., Zemans, R. L., Zimmerman, G. A., Arabi, Y. M., Beitler, J. R., Mercat, A., Herridge, M., Randolph, A. G., & Calfee, C. S. (2019). Acute respiratory distress syndrome. Nature Reviews Disease Primers, 5(1), 1-22. https://doi.org/10.1038/s41572-019-0069-0
Orloff, K. E., Turner, D. A., & Rehder, K. J. (2019). The current state of pediatric acute respiratory distress syndrome. Pediatric Allergy, Immunology, and Pulmonology, 32(2), 35-44. https://doi.org/10.1089/ped.2019.0999
Kogan, A., Segel, M., Ram, E., Raanani, E., Peled-Potashnik, Y., Levin, S., & Sternik, L. (2019). Acute respiratory distress syndrome following cardiac surgery: Comparison of the American-European consensus conference definition versus the Berlin definition. Respiration, 97(6), 518-524. https://doi.org/10.1159/000495511
Khemani, R. G., Smith, L., Lopez-Fernandez, Y. M., Kwok, J., Morzov, R., Klein, M. J., ... & Kustka, L. (2019). Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study. The Lancet Respiratory Medicine, 7(2), 115-128.
Yehya, N., Thomas, N. J., & Khemani, R. G. (2018). Risk stratification using oxygenation in the first 24 hours of pediatric acute respiratory distress syndrome*. Critical Care Medicine, 46(4), 619-624. https://doi.org/10.1097/ccm.0000000000002958
Ahmed, R., Azim, A., Nangialay, A., Haque, A., & Jurair, H. (2019). Frequency of pediatric acute respiratory distress syndrome based on oxygen saturation index in pediatric intensive care unit of a developing country. Cureus, 11(12). https://doi.org/10.7759/cureus.6444
Spicer, A. C., Calfee, C. S., Zinter, M. S., Khemani, R. G., Lo, V. P., Alkhouli, M. F., Orwoll, B. E., Graciano, A. L., Boriosi, J. P., Howard, J. P., Flori, H. R., Matthay, M. A., & Sapru, A. (2016). A simple and robust bedside model for mortality risk in pediatric patients with acute respiratory distress syndrome*. Pediatric Critical Care Medicine, 17(10), 907-916. https://doi.org/10.1097/pcc.0000000000000865
Wang, T., Liu, Z., Wang, Z., Duan, M., Li, G., Wang, S., Li, W., Zhu, Z., Wei, Y., Christiani, D. C., Li, A., & Zhu, X. (2014). Thrombocytopenia is associated with acute respiratory distress syndrome mortality: An international study. PLoS ONE, 9(4), e94124. https://doi.org/10.1371/journal.pone.0094124
Mirza, S., Malik, L., Ahmed, J., Malik, F., Sadiq, H., Ali, S., & Aziz, S. (2020). Accuracy of pediatric risk of mortality (PRISM) III score in predicting mortality outcomes in a pediatric intensive care unit in Karachi. Cureus. https://doi.org/10.7759/cureus.7489
Schene, K. M., Van den Berg, E., Wösten-van Asperen, R. M., Van Rijn, R. R., Bos, A. P., & Van Woensel, J. B. (2013). FiO2 predicts outcome in infants with respiratory syncytial virus‐induced acute respiratory distress syndrome. Pediatric Pulmonology, 49(11), 1138-1144. https://doi.org/10.1002/ppul.22974
Cheifetz, I. M. (2016). Year in review 2015: Pediatric ARDS. Respiratory Care, 61(7), 980-985. https://doi.org/10.4187/respcare.05017
Li Bassi, G., Comaru, T., Martí, D., Xiol, E., Chiurazzi, C., Travierso, C., Carbonara, M., Ranzani, O., Amaro, R., Frigola, G., Fuster, C., Saco, M., Zanella, A., De Rosa, F., Rigol, M., Fernandez, L., Luque, N., Ramirez, J., Blasi, F., … Torres, A. (2019). Recruitment manoeuvres dislodge mucus towards the distal airways in an experimental model of severe pneumonia. British Journal of Anaesthesia, 122(2), 269-276. https://doi.org/10.1016/j.bja.2018.07.039
Yohannan, L. M. (2019). Incidence and outcome of pulmonary complications after cardiac surgery (Master's thesis, Lithuanian University of Health Sciences (Lithuania)).
De Luca, D., Piastra, M., Tosi, F., Pulitano, S., Mancino, A., Genovese, O., Pietrini, D., & Conti, G. (2012). Pharmacological therapies for pediatric and neonatal ALI/ARDS: An evidence-based review. Current Drug Targets, 13(7), 906-916. https://doi.org/10.2174/138945012800675687
Nayani, K., Naeem, R., Munir, O., Naseer, N., Feroze, A., Brown, N., & Mian, A. I. (2018). The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department. BMC Pediatrics, 18(1). https://doi.org/10.1186/s12887-018-1317-2
Crowe, L., Chang, A., & Wallace, K. (2012). Instruments for assessing readiness to commence suck feeds in preterm infants: Effects on time to establish full oral feeding and duration of hospitalisation. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd005586.pub2
De Luca, D., Van Kaam, A. H., Tingay, D. G., Courtney, S. E., Danhaive, O., Carnielli, V. P., Zimmermann, L. J., Kneyber, M. C., Tissieres, P., Brierley, J., Conti, G., Pillow, J. J., & Rimensberger, P. C. (2017). The Montreux definition of neonatal ards: Biological and clinical background behind the description of a new entity. The Lancet Respiratory Medicine, 5(8), 657-666. https://doi.org/10.1016/s2213-2600(17)30214-x
Amigoni, A., Pettenazzo, A., Stritoni, V., & Circelli, M. (2017). Surfactants in acute respiratory distress syndrome in infants and children: Past, present and future. Clinical Drug Investigation, 37(8), 729-736. https://doi.org/10.1007/s40261-017-0532-1
Qari, S. A., Alsufyani, A. A., & Muathin, S. H. (2018). Prevalence of respiratory distress syndrome in neonates. The Egyptian Journal of Hospital Medicine, 70(2), 257-264. https://doi.org/10.12816/0043086
Chen, L., Wang, L., Ma, J., Feng, Z., Li, J., & Shi, Y. (2019). Nasal high-frequency oscillatory ventilation in preterm infants with respiratory distress syndrome and ARDS after Extubation. Chest, 155(4), 740-748. https://doi.org/10.1016/j.chest.2019.01.014
Đorđević, I., Slavković, A., Slavković-Jovanović, M., & Marjanović, Z. (2010). Influence of risk factors on frequency and prognosis of neonatal pneumothorax, five-year experience. Acta Medica Medianae, 49(2). https://publisher.medfak.ni.ac.rs/AMM_1/amm-stari/2010-html/2-broj/Ivona%20%C3%90ordevic-Influence%20of%20risk%20factors.pdf
Siavashi, V., Asadian, S., Taheri-Asl, M., Babaei, H., Keshavarz, S., Bazaei, M., & Nassiri, S. M. (2016). The improvement of respiratory performance after phototherapy-induced EPC mobilization in preterm infants with RDS. Journal of Cellular Biochemistry, 118(3), 594-604. https://doi.org/10.1002/jcb.25745
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