Affiliation:
1. Universidad de los Andes, Hospital Universitario Fundación Santa Fe de Bogotá. Bogotá
2. Universidad de los Andes. Bogotá
3. Clinica Infantil Colsubsidio
Abstract
Abstract
Background: Acute respiratory failure (ARF) is the most frequent cause of cardiorespiratory arrest and subsequent death in children worldwide, therefore several efforts have been made to better understand its etiology and risk factors for further progression (1–4). The aim of this study was to calculate mortality and describe associated factors for severity and mortality in children with acute respiratory failure.
Methods: The study was conducted within a prospective multicentric cohort that evaluated the natural history of pediatric acute respiratory failure (ARF). For this analysis three primary outcomes were studied: mortality, invasive mechanical ventilation, and pediatric intensive care unit length of stay.
Setting: Pediatric emergency, in-hospital, and critical care services in three hospitals in Bogotá, Colombia, from April 2020 to June 2021.
Patients: Eligible patients were children older than 1 month and younger than 18 years of age with respiratory difficulty at time of admission. Patients who developed ARF were followed at time of ARF, 48 hours later, at time of admission and at 30 and 60 days after discharge.
Measurements and main results: Out of a total of 685 eligible patients, 296 developed ARF for a calculated incidence of ARF of 43.2%. Of the ARF group, ninety patients (30.4%) needed orotracheal intubation, for a mean of 9.57 days of ventilation (interquartile range = 3.00–11.5). Incidence of mortality was 6.1% (n= 18). The associated factors for mortality in ARF were a history of a neurologic comorbidity and a higher fraction of inspired oxygen at ARF diagnosis. For PICU length of stay associated factors were age between 2 and 5 years of age, exposure to smokers, and respiratory comorbidity. Finally, for mechanical ventilation, the risk factors were obesity and being unstable at admission.
Conclusions: ARF is a common cause of morbidity and mortality in children. Understanding the factors associated with greater mortality and severity of ARF might allow earlier recognition and initiation of prompt treatment strategies.
Publisher
Research Square Platform LLC
Reference41 articles.
1. Acute Respiratory Failure in Children;Friedman ML;Pediatr Ann,2018
2. Kopp W, Gedeit RG, Asaro LA et al. The Impact of Preintubation Noninvasive Ventilation on Outcomes in Pediatric Acute Respiratory Distress Syndrome [Internet]. Crit Care Med 2021; 49:816–827[cited 2022 Nov 2] Available from: https://pubmed-ncbi-nlm-nih-gov.ezproxy.javeriana.edu.co/33590999/
3. Epidemiology of pediatric acute respiratory distress syndrome in singapore: risk factors and predictive respiratory indices for mortality;Wong JJ-M;Front Pediatr,2014
4. Evolution of Noninvasive Mechanical Ventilation Use: A Cohort Study Among Italian PICUs;Wolfler A;Pediatr Crit Care Med,2015
5. Flori H, Dahmer MK, Sapru A et al. Comorbidities and assessment of severity of pediatric acute respiratory distress syndrome: Proceedings from the Pediatric Acute Lung Injury Consensus Conference. In: Pediatric Critical Care Medicine. Lippincott Williams and Wilkins; 2015. p. S41–S50.