Mortality and morbidity of acute hypoxemic respiratory failure and acute respiratory distress syndrome in infants and young children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acute hypoxemic respiratory failure (AHRF) often develops acute respiratory distress syndrome (ARDS), and its incidence and mortalities in critically ill pediatric patients in China were 2% and 40% respectively. This study aimed at prospectively investigating incidence, causes, mortality and its risk factors, and any relationship to initial tidal volume (V(T)) levels of mechanical ventilation, in children £5 years of age with AHRF and ARDS.</p><p><b>METHODS</b>In 12 consecutive months in 23 pediatric intensive care units (PICU), AHRF and ARDS were identified in those requiring > 12 hour intratracheal mechanical ventilation and followed up for 90 days or until death or discharge. ARDS was diagnosed according to the American-European Consensus definitions. The mortality and ventilation free days (VFD) were measured as the primary outcome, and major complications, initial disease severity, and burden were measured as the secondary outcome.</p><p><b>RESULTS</b>In 13 491 PICU admissions, there were 439 AHRF, of which 345 (78.6%) developed ARDS, resulting in incidences of 3.3% and 2.6%, and corresponding mortalities of 30.3% and 32.8% respectively along with 8.2 and 6.7 times of relative risk of death in those with pneumonia (62.9%) and sepsis (33.7%) as major underlying diseases respectively. No association was found in V(T) levels during the first 7 days with mortality, nor for V(T) at levels < 6, 6 - 8, 8 - 10, and > 10 ml/kg in the first 3 days with mortality or length of VFD. By binary Logistic regression analyses, higher pediatric risk of mortality score III, higher initial oxygenation index, and age < 1 year were associated with higher mortality or shorter VFD in AHRF.</p><p><b>CONCLUSIONS</b>The incidence and mortalities of AHRF and ARDS in children £5 years were similar to or lower than the previously reported rates (in age up to 15 years), associated with initial disease severity and other confounders, but causal relationship for the initial V(T) levels as the independent factor to the major outcome was not found.</p>

Analysis on pedestrian traffic injury among aged 0-14 years children in Guangzhou, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the characteristics of child pedestrian traffic injuries among aged 0-14 years old in Guangzhou city and to provide information on road, vehicle and human injuries in pedestrian.</p><p><b>METHODS</b>A database of all motor vehicle crashes involving child pedestrian traffic injury cases over a five-year period (2000-2004), was from the police department.</p><p><b>RESULTS</b>The annual pedestrian traffic injury rates on incidence, mortality and case fatality were 17.63/ 1,100,000, 1.78/ 100,000 and 10.07% respectively. Both incidence rate and mortality peaked in the 5-9 age group were 26.80/ 100,000 and 2.57/ 100,000, with case fatality peaked in the 0-4 age group (13.29%). For males, the incidence (20.98/ 100,000) and mortality (2.00/ 100,000) were higher than that in females (13.83/ 100,000, and 1.52/ 100,000). The main injured parts of body would include multi-areas (40.34%), head (26.75%) and lower limbs (21.53%). 10.07% of the cases died and 66.18% and 23.75% of them having had severe and slight injures. The major causes were due to drivers (57.50%) and pedestrians (33.47%) faults with top three responsible vehicles were cars (40.14%), two-wheeled motorcycles (34.38%) and vans (22.15%).</p><p><b>CONCLUSION</b>Data from pediatric pedestrian injury poses a threat to children and adolescents, data suggesting that it is important to change behaviors of both drivers and pedestrians.</p>