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Updated: Jan 5, 2026
Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
[Nested case-control study on paediatric early warning score and ventilator-associated complications in children with
Yanhui Lu1, Zhenkui Liu1, Shiyang Li1
1Department of Pediatrics, First Affiliated Hospital of Hebei North University, Zhangjiakou Hebei 075000, China.
Insights
The Paediatric Early Warning Score (PEWS) can help predict mechanical ventilation complications in children with acute respiratory distress syndrome (ARDS). Combining PEWS with other indicators improves risk assessment for these critically ill children.
Area of Science:
- Pediatric Critical Care Medicine
- Respiratory Medicine
- Intensive Care Unit Management
Background:
- Acute respiratory distress syndrome (ARDS) in children presents significant management challenges.
- Mechanical ventilation is crucial for ARDS management but carries risks of complications.
- Predictive tools are needed to identify children at higher risk of developing complications during mechanical ventilation.
Purpose of the Study:
- To investigate the association between the Paediatric Early Warning Score (PEWS) and the incidence of mechanical ventilation complications.
- To identify key clinical and physiological factors influencing complication development in pediatric ARDS patients.
Main Methods:
- A nested case-control study involving 110 children with ARDS requiring mechanical ventilation.
- Data collected included baseline characteristics, blood gas analysis, laboratory tests, ventilator parameters, Pediatric Critical Illness Score (PCIS), and PEWS.
- Statistical analyses included independent sample t-tests and multivariate logistic regression.
Main Results:
- Significant differences were observed between groups with and without complications in multiple organ dysfunction syndrome (MODS), PaO2/FiO2, PaCO2, serum creatinine, albumin, BUN, ventilation duration, MAP, tidal volume (VT), PEEP, PCIS, and PEWS.
- Multivariate analysis identified MODS, PaO2/FiO2, PaCO2, VT, PEEP, and PEWS as significant predictors of mechanical ventilation complications.
Conclusions:
- MODS, gas exchange parameters (PaO2/FiO2, PaCO2), ventilator settings (VT, PEEP), and PEWS are associated with mechanical ventilation complications in pediatric ARDS.
- PEWS, when used in conjunction with other clinical indicators, can effectively assess the risk of complications in children with ARDS undergoing mechanical ventilation.
Objective:
To explore the relationship between paediatric early warning score (PEWS) and the occurrence of mechanical ventilation complications in children with acute respiratory distress syndrome (ARDS). Methods: A total of 110 children with ARDS diagnosed in First Affiliated Hospital of Hebei North University, who underwent mechanical ventilation, were selected. The baseline data, blood gas analysis index, laboratory test index, ventilator parameters, pediatric critical illness score (PCIS) and PEWS in the children were recorded. With reference to ventilatory treatment results, the children with ventilator-associated complications were included in the trial group (n=20), while the patients with good cohort status were included in the control group (n=40) according to the nested case-control study. Independent sample t-test and multivariate logistic regression analysis were used to analyze the factors affecting the occurrence of complications after ventilatory treatment. Results: There were statistically significant differences in multiple organ dysfunction syndrome (MODS), partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2), partial pressure of carbon dioxide (PaCO2), serum creatinine (SCr), albumin (ALB), blood urea nitrogen (BUN), mechanical ventilation time, mean article pressure (MAP), tidal volume (VT), positive end-expiratory pressure (PEEP), PCIS, PEWS between the control group and the experimental group (all P<0.05). Multivariate logistic regression analysis showed that MODS, PaO2/FiO2, PaCO2, VT, PEEP and PEWS had influence on complications after mechanical ventilation in children with ARDS (all P<0.05). Conclusion: The MODS, PaO2/FiO2, PaCO2, VT, PEEP, and PEWS exert effects on complications after mechanical ventilation in children with ARDS. PEWS combined with other indicators can assess the risk of complications in children with ARDS after mechanical ventilation.
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