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Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit

Cilt: 46 Sayı: 2 30 Haziran 2021
İnci Turhan , Dinçer Yıldızdaş , Ahmet Yöntem *
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Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit

Öz

Purpose: The aim of this study was to evaluate the lung-protective mechanical ventilation strategy, early enteral nutrition, negative fluid balance, and adequacy of hospital resources in our pediatric intensive care unit. Materials and Methods: This study included 32 patients who developed acute respiratory distress syndrome (ARDS) during their monitoring in the pediatric intensive care unit. Results: According to their oxygenation status, 14 patients (43.8%) had mild ARDS, nine patients (28.1%) had moderate ARDS, and nine patients (28.1%) had severe ARDS. High-frequency oscillatory ventilation was applied to three patients (9.3%), and four patients (12.5%) received extracorporeal membrane oxygenation (ECMO) support. The most common complications were nosocomial infection (31.3%) and pneumothorax (12.5%). The mortality rate was 6.3%. The survival rate was 75.0% in patients with ECMO support. The patients with a higher Pediatric Index of Mortality (PIM-2) score confronted more severe ARDS, and non-pulmonary ARDS also progressed in advanced stages. Conclusion: In patients with high PIM-2 and PELOD scores, attention must be given to the development of severe ARDS. The lung-protective mechanical ventilation support, early enteral nutrition, negative fluid balance practices, and the adequacy of hospital resources led to a successful survival rate in our study. However, multicenter randomized controlled trials are needed on this subject.

Anahtar Kelimeler

Acute Respiratory Distress Syndrome, PICU, Children, Stage, Survival

Kaynakça

  1. Referans1 Khemani RG, Smith LS, Zimmerman JJ, Erickson S; Pediatric Acute Lung Injury Consensus Conference Group. Pediatric Acute Lung Injury Consensus Conference Group: Pediatric acute respiratory distress syndrome: Definition, incidence, and epidemiology: Proceedings from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med 2015;16:23–40.
  2. Referans2 Khemani RG, Smith L, Lopez-Fernandez YM, Kwok J, Morzov R, Klein MJ, et al. Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology (PARDIE): An international, observational study. Lancet Respir Med 2019;7:115–28.
  3. Referans3 López-Fernández Y, Azagra AM, de la Oliva P, Modesto V, Sánchez JI, Parrilla J, et al. Pediatric Acute Lung Injury Epidemiology and Natural History study: Incidence and outcome of the acute respiratory distress syndrome in children. Crit Care Med 2012;40:3238-45.
  4. Referans4 Kneyber MC, Brouwers AG, Caris JA, Chedamni S, Plötz FB. Acute respiratory distress syndrome: is it underrecognized in the pediatric intensive care unit?. Intensive Care Med 2008;34:751-4.
  5. Referans5 Dowell JC, Parvathaneni K, Thomas NJ, Khemani RG, Yehya N. Epidemiology of cause of death in pediatric acute respiratory distress syndrome. Crit Care Med 2018;46:1811–9.
  6. Referans6 Yadav B, Bansal A, Jayashree M. Clinical Profile and Predictors of Outcome of Pediatric Acute Respiratory Distress Syndrome in a PICU: A Prospective Observational Study. Pediatr Crit Care Med 2019;20:263–73.
  7. Referans7 Villar J, Blanco J, Añón JM, Santos-Bouza A, Blanch L, Ambrós A, et al. The ALIEN study: Incidence and outcome of acute respiratory distress syndrome in the era of lung-protective ventilation. Intensive Care Med 2011;37:1932–41.
  8. Referans8 Villar J, Blanco J, Kacmarek RM. Current incidence and outcome of the acute respiratory distress syndrome. Curr Opin Crit Care 2016;22:1–6.
  9. Referans9 Ten I, Torres A. Pediatric Acute Respiratory Distress Syndrome Mortality in the 21st Century: Nature, Nurture, Location, and?. Pediatr Crit Care Med 2019;20:584–5.
  10. Referans10 Thomas NJ, Shaffer ML, Willson DF, Shih MC, Curley MA. Defining acute lung disease in children with the oxygenation saturation index. Pediatr Crit Care Med 2010;11:12–7.

Kaynak Göster

APA
Turhan, İ., Yıldızdaş, D., & Yöntem, A. (2021). Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit. Cukurova Medical Journal, 46(2), 516-522. https://doi.org/10.17826/cumj.850659
AMA
1.Turhan İ, Yıldızdaş D, Yöntem A. Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit. Cukurova Med J. 2021;46(2):516-522. doi:10.17826/cumj.850659
Chicago
Turhan, İnci, Dinçer Yıldızdaş, ve Ahmet Yöntem. 2021. “Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit”. Cukurova Medical Journal 46 (2): 516-22. https://doi.org/10.17826/cumj.850659.
EndNote
Turhan İ, Yıldızdaş D, Yöntem A (01 Haziran 2021) Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit. Cukurova Medical Journal 46 2 516–522.
IEEE
[1]İ. Turhan, D. Yıldızdaş, ve A. Yöntem, “Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit”, Cukurova Med J, c. 46, sy 2, ss. 516–522, Haz. 2021, doi: 10.17826/cumj.850659.
ISNAD
Turhan, İnci - Yıldızdaş, Dinçer - Yöntem, Ahmet. “Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit”. Cukurova Medical Journal 46/2 (01 Haziran 2021): 516-522. https://doi.org/10.17826/cumj.850659.
JAMA
1.Turhan İ, Yıldızdaş D, Yöntem A. Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit. Cukurova Med J. 2021;46:516–522.
MLA
Turhan, İnci, vd. “Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit”. Cukurova Medical Journal, c. 46, sy 2, Haziran 2021, ss. 516-22, doi:10.17826/cumj.850659.
Vancouver
1.İnci Turhan, Dinçer Yıldızdaş, Ahmet Yöntem. Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit. Cukurova Med J. 01 Haziran 2021;46(2):516-22. doi:10.17826/cumj.850659