Acute respiratory distress syndrome: is it underrecognized in the pediatric intensive care unit?

Content Provider	Europe PMC
Author	Kneyber, Martin C. J. Brouwers, Arno G. A. Caris, Jochem A. Chedamni, Sunita Plötz, Frans B.
Abstract	ObjectiveTo describe the incidence of acute respiratory distress syndrome (ARDS) in mechanically ventilated children and to study whether ARDS is underrecognized in this patient population.Design and settingRetrospective observational study in a single-center bed pediatric intensive care unit serving two Dutch provinces.Patients533 mechanically ventilated children aged 0–16 years, all of whom met the North-American European Consensus Conference criteria for ARDS.Measurements and resultsChest radiographs were screened for the novel presence of bilateral infiltrates, in patients with bilateral infiltrates the PaO2/FIO2 ratio was calculated on two separate consecutive measurements. If below 200, the patient was classified as having ARDS. Left ventricular dysfunction was ruled out by echocardiography. The incidence was calculated by obtaining the number of children aged 0–16 years in our region. For each patient it was noted whether the patient was currently considered to have ARDS. Forty-one patients (7.7%) met the criteria for ARDS, with an incidence of 2.2 per 100,000 per year. The mortality rate was 20.4%. Thirty patients (73.1%) had primary ARDS, mainly from viral lower respiratory tract disease. Only ten patients (24.4%) currently had ARDS.ConclusionsThe incidence of pediatric ARDS is low compared to that of adult ARDS, and further underestimated as most patients were diagnosed by their underlying diseases.
ISSN	03424642
Journal	Intensive Care Medicine
Volume Number	34
PubMed Central reference number	PMC7095351
Issue Number	4
PubMed reference number	18288473
e-ISSN	14321238
DOI	10.1007/s00134-008-1029-4
Language	English
Publisher	Springer-Verlag
Publisher Date	2008-02-21
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. © Springer-Verlag 2008
Subject Keyword	Acute respiratory distress syndrome Mechanically ventilated Pediatric intensive care unit The Netherlands Underdiagnoses
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine