Retrospective evaluation of patients with acute respiratory distress syndrome (ARDS) followed by mechanical ventilator in our pediatric intensive care unit

Retrospective evaluation of patients with acute respiratory distress syndrome (ARDS) followed by mechanical ventilator in our pediatric intensive care unit Mehmet Geyik Acute respiratory distress syndrome (ARDS) is a non-cardiogenic acute lung injury that affects both lungs due to increased permeability of the alveolo-capillary membrane. There are not enough studies on this subject in our country. The aim of this study was to investigate the clinical, demographic and laboratory characteristics of patients followed up in our pediatric intensive care unit with the diagnosis of ARDS and to determine the factors that affect survival. This retrospective study was performed with the data of 40 patients who were followed in mechanical ventilator out of 3034 patients who were followed up in Adiyaman University Faculty of Medicine Pediatric Intensive Care Unit between 2013-2018. Clinical and laboratory characteristics, mechanical ventilator parameters, pediatric intensive care mortality (PIM, PIM-II, PRISM) and organ failure scores (PELOD) were evaluated. The analyzes were performed using SPSS 23 package program using Chi-square, Fisher and Mann Whitney U Tests. The study group consisted of 18 girls (45%) and 22 boys (55%). The mean age of the patients was 45.25 ± 56.63 months. The most common diagnosis was pneumonia (40%). Twenty-seven (67.5%) of the ARDS patients were classified as pulmonary and 13 (32.5%) as extrapulmonary ARDS. 16 people (40%) were followed in pressure controlled mode, 2 (5%) in volume controlled mode, and 22 (55%) in both pressure and volume controlled mode. The median value of the patients in the ICU was 17.5 days and the median duration of the mechanical ventilator was 276.5 hours. Seventeen (42.5%) patients died without any response to treatment. PIM, PIM-II, PELOD scores, PIP, PEEP and SPEED values and dobutamine use rates were significantly lower in the surviving patients. The duration of ICU stay and mechanical ventilator stay were shorter in patients who died. PIM, PIM-II, PRISM and PELOD scores, urea and creatinine levels were lower and pH and HCO3 levels were higher in pulmonary ARDS patients. ARDS patients could be treated effectively in our intensive care unit. Despite all efforts, some of the patients died. The mean PIM, PIM-II, PELOD scores, PIP, PEEP and SPEED values and presence of inotropic requirement were found to be significantly higher in the patients who died. Also; mean length of stay in ICU and duration of stay in mechanical ventilator were also significantly lower in patients who died. Our results should be supported by multicentre studies with a large number of patients. Keywords: ARDS, Mechanical Ventailator, Survival, Scoring, Pediatric