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Clinical profile and outcome of acute respiratory failure

Sunil Karande1, Rajneesh Murkey, Sanjeev Ahuja

  • 1Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India. karandesunil@yahoo.com

Indian Journal of Pediatrics
|January 2, 2004
PubMed

Insights

Acute respiratory failure in children has diverse causes and symptoms, leading to a high mortality rate. Malnutrition and Type I failure significantly worsen outcomes, regardless of age or primary condition.

Area of Science:

  • Pediatric Critical Care
  • Respiratory Medicine
  • Neonatology

Background:

  • Acute respiratory failure (ARF) in children presents a significant clinical challenge with varied etiologies.
  • Understanding the spectrum of causes, clinical presentations, and outcomes is crucial for effective management.

Purpose of the Study:

  • To investigate the etiological factors contributing to acute respiratory failure in pediatric patients.
  • To describe the clinical features, treatment strategies, and outcomes associated with ARF in children.
  • To identify factors influencing the prognosis of pediatric acute respiratory failure.

Main Methods:

  • A prospective observational study involving 50 children diagnosed with ARF via serial arterial blood gas analysis.
  • Data collection spanned 15 months in a hospital-based setting.
  • Ventilation therapy was initiated based on a fraction of inspired oxygen (FiO2) requirement exceeding 0.6.

Main Results:

  • Pulmonary diseases, primarily bronchopneumonia, were the leading cause of ARF (68%).
  • Common clinical signs included altered respiration patterns, chest wall retractions, nasal flaring, tachypnea, tachycardia, and irritability.
  • The overall mortality rate was 58%, with significantly higher mortality linked to malnutrition, Type I failure, and the need for ventilation therapy.

Conclusions:

  • Acute respiratory failure in children exhibits diverse etiologies and clinical manifestations, characterized by a high mortality rate.
  • Outcomes are not dependent on the child's age or the primary system affected.
  • Co-existent malnutrition and Type I respiratory failure are identified as significant predictors of poor outcomes in pediatric ARF.
Abstract

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