The Pattern of Pediatric Acute Respiratory Distress Syndrome over 10 Years Period and Related Risk Factors of its Outcome Mortality

Abstract

Background: Although paediatric acute respiratory distress syndrome (PARDS) is a common and devastating clinical syndrome that contributes to high morbidity and mortality, there is little known about its pattern and outcome mortality over time. Objective: This study aimed to determine the pattern of PARDS over a 10-year period and the risk factors for its outcome, mortality. Methods: This study was done at King Fahd University Hospital in Saudi Arabia using a retrospective study design involving children aged from > 2 weeks to 14 years admitted to the PICU due to PARDS. Over the last ten years, data was extracted from their medical records. Results: The number of PICU admissions over the last ten years was 2317, the rate of PARDS amongst PICU admissions was 376/2317 (16.23%), and mortality amongst PARDS cases was 83/376 (22.07%). ER admission route, chronic liver disease, sepsis, fluid overload, the number of inotropes 3, and pneumonia mediastinum were significant predictors of mortality in PARDS (p 0.001). In addition, the mean PRISM III score, PICU admission days, and ventilation days were higher in the deceased than in the survivors of PARDS. In contrast, the mean PaO2/FIO2 and oxygen saturation indices were significantly lower among the deceased than the survivors (p 0.01). Conclusion: Although the rate of PARDS was alarming, the number of PARDS deaths was constant over the study period. Sepsis, ER admission route, comorbidities, fluid overload, a higher PRISM III score, longer PICU admission, and ventilation days increased the risk of PARDS mortality.