A Nationwide Clinical Study of Acute Respiratory Distress Syndrome in Children

ABSTRACT

PURPOSE: Acute respiratory distress syndrome(ARDS) is the final course of acute lung injury. It results from various etiological origins and pathophysiologic mechanisms, and has a mortality rate of approximately 60-70%. Although the confirmative incidence of ARDS in children is yet unknown, the increasing incidence of ARDS has been reported in Korea. In the present study, we report ARDS diagnosed at the Clinic for Pediatric Allergy and Respiratory Disease in eleven medical centers nationwide. METHODS: The study was conducted on 42 patients diagnosed with ARDS in Pediatric Allergy and Respiratory Clinics from January, 1995 to August, 1997. We analyzed the clinical course and treatment modalities of the 42 cases of ARDS retrospectively. RESULTS: The total number of patients recruited was 42, including seventeen(40.4%) below 1-year-old. The mean age was 2.0+/-2.3(mean+/-standard deviation) years with a range of 2 months to 10 years, and there was no sex predominance(male/female 27/15). Twenty-one cases(50.0%) occured during the spring(March, April and May). The major triggering factors of ARDS were viral pneumonia(59.5%) and bacterial pneumonia (19.1%). Mechanical ventilation was used in 37 cases(88.1%). Major complications included pneumothorax, DIC, and gastrointestinal bleeding. The mortality rate was 61.9% of which 16 case (61.5%) occurred before 2 years of age. CONCLUSION: We conducted this study to make a rapid diagnosis and appropriate treatment of ARDS in children, who have major risk factors, to reduce its mortality rate.