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

Martin C J Kneyber1, Arno G A Brouwers, Jochem A Caris

  • 1Department of Pediatric Intensive Care, V.U. University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. m.kneyber@vumc.nl

Intensive Care Medicine
|February 22, 2008
PubMed

Insights

The incidence of pediatric acute respiratory distress syndrome (ARDS) is low, with only 7.7% of mechanically ventilated children meeting the criteria. Most cases were underrecognized, highlighting a need for improved diagnosis in pediatric intensive care units.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory medicine
  • Epidemiology

Background:

  • Acute Respiratory Distress Syndrome (ARDS) is a significant cause of morbidity and mortality in critically ill children.
  • Accurate incidence data and recognition of pediatric ARDS are crucial for effective management and research.

Purpose of the Study:

  • To determine the incidence of ARDS in mechanically ventilated children.
  • To assess the extent to which ARDS is underrecognized in this population.

Main Methods:

  • Retrospective observational study in a single-center pediatric intensive care unit.
  • Inclusion of 533 mechanically ventilated children (0-16 years) meeting ARDS criteria.
  • Diagnosis confirmed by chest radiography, PaO2/FIO2 ratio, and exclusion of left ventricular dysfunction.

Main Results:

  • Forty-one patients (7.7%) met ARDS criteria, with an incidence of 2.2 per 100,000 children annually.
  • Mortality rate was 20.4%; 73.1% had primary ARDS, often due to viral infections.
  • A significant proportion (75.6%) of ARDS cases were not recognized at the time of the study.

Conclusions:

  • The incidence of pediatric ARDS is lower than in adults but likely underestimated.
  • Underrecognition is a major issue, with most pediatric ARDS cases diagnosed based on underlying conditions rather than ARDS itself.
Abstract

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