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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
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Incidence and outcomes of pediatric acute lung injury

Jerry J Zimmerman1, Saadia R Akhtar, Ellen Caldwell

  • 1Division of Pediatric Critical Care Medicine, Seattle Children's Hospital, Harborview Medical Center, University of Washington, Seattle, Washington 98105-0371. jerry.zimmerman@seattlechildrens.org.

Pediatrics
|July 1, 2009
PubMed

Insights

This study determined the incidence of pediatric acute lung injury (ALI) in the US, finding lower rates and mortality compared to adults. Further research may need outcomes beyond death for clinical trials.

Area of Science:

  • Pediatric critical care medicine
  • Epidemiology
  • Respiratory medicine

Background:

  • Pediatric acute lung injury (ALI) is a critical condition with limited population-based incidence data in the United States.
  • Understanding ALI incidence and outcomes is crucial for improving pediatric critical care.

Purpose of the Study:

  • To establish the first population-based incidence and outcomes of pediatric acute lung injury (ALI) in the United States.
  • To compare pediatric ALI incidence and mortality with adult populations.

Main Methods:

  • A prospective, population-based cohort study conducted in King County, Washington, from 1999-2000.
  • Screened critically ill children (0.5-15 years) requiring mechanical ventilation, applying North American-European Consensus Conference criteria for ALI.
  • Exclusion of postoperative patients with <24 hours of ventilation; data collection on risk factors, demographics, and mortality; incidence estimated using US Census data.

Main Results:

  • Thirty-nine pediatric cases of ALI were identified, yielding an incidence of 12.8 per 100,000 person-years.
  • Severe sepsis with pneumonia was the most frequent risk factor; hospital mortality was 18%, lower than adult ALI.
  • No significant associations found between age, gender, or risk factors and patient outcomes.

Conclusions:

  • This study provides the first US population-based incidence estimate for pediatric acute lung injury (ALI).
  • Pediatric ALI incidence and mortality rates are lower than those observed in adult populations.
  • The low mortality rate in pediatric ALI suggests that clinical trials may need to consider alternative outcome measures beyond death.
Abstract

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