Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit

Abstract

Purpose: The aim of this study was to evaluate the lung-protective mechanical ventilation strategy, early enteral nutrition, negative fluid balance, and adequacy of hospital resources in our pediatric intensive care unit.

Materials and Methods: This study included 32 patients who developed acute respiratory distress syndrome (ARDS) during their monitoring in the pediatric intensive care unit.

Results: According to their oxygenation status, 14 patients (43.8%) had mild ARDS, nine patients (28.1%) had moderate ARDS, and nine patients (28.1%) had severe ARDS. High-frequency oscillatory ventilation was applied to three patients (9.3%), and four patients (12.5%) received extracorporeal membrane oxygenation (ECMO) support. The most common complications were nosocomial infection (31.3%) and pneumothorax (12.5%). The mortality rate was 6.3%. The survival rate was 75.0% in patients with ECMO support. The patients with a higher Pediatric Index of Mortality (PIM-2) score confronted more severe ARDS, and non-pulmonary ARDS also progressed in advanced stages.

Conclusion: In patients with high PIM-2 and PELOD scores, attention must be given to the development of severe ARDS. The lung-protective mechanical ventilation support, early enteral nutrition, negative fluid balance practices, and the adequacy of hospital resources led to a successful survival rate in our study. However, multicenter randomized controlled trials are needed on this subject.