American Journal of Pediatrics

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Outcome Comparison Between Pulmonary and Extrapulmonary Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit

Received: 09 October 2020    Accepted: 22 October 2020    Published: 30 October 2020
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Abstract

Acute respiratory distress syndrome (ARDS) is a lung disease characterized by severe diffuse inflammation and hypoxemia. The cause of ARDS can be pulmonary or extrapulmonary originated. The outcome of pulmonary and extrapulmonary pediatric ARDS are poorly described. The objective of this study was to determine the outcome differences between pulmonary and extrapulmonary pediatric ARDS. A retrospective study was carried out in 60 patients who admitted to the Pediatric Intensive Care Unit (PICU), Sanglah Hospital, between January 2018 until December 2019. All children aged 0-18 years old diagnosed with ARDS according to Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria were included in this study. Length of ventilation, ventilator-free days, PICU length of stay, and PICU mortality as the outcome of this study were obtained from medical records. Statistical analysis was done using Chi-square and Mann-Whitney test. Most of the patients were supported by invasive ventilation with the severity of ARDS was mild to moderate. The underlying disease of pulmonary ARDS (ARDSp) was pneumonia (100%), whereas in extrapulmonary ARDS (ARDSexp) was sepsis (100%). Analysis of outcome showed significant difference in mortality (33.3% vs 73.3%, p=0.002). The mortality was higher among those in the moderate severity of oxygenation index (64.5%, p=0.001). No significant difference was found in length of ventilation and PICU length of stay. The ventilator-free days in ARDSp was higher (22 days vs 0 days, p=0.000) compared with the ARDSexp. This study concluded that patients with extrapulmonary ARDS had poorer outcomes (higher mortality and less ventilator-free day) compared with pulmonary ARDS. The severity of ARDS based on the oxygenation index measurement can be used to discriminate mortality.

DOI 10.11648/j.ajp.20200604.19
Published in American Journal of Pediatrics (Volume 6, Issue 4, December 2020)
Page(s) 442-447
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pediatric, Pulmonary and Extrapulmonary ARDS, Outcome

References
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Author Information
  • Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia

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    Ni Made Reditya Noviyani, Ida Bagus Gede Suparyatha, Dyah Kanya Wati, I Nyoman Budi Hartawan. (2020). Outcome Comparison Between Pulmonary and Extrapulmonary Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit. American Journal of Pediatrics, 6(4), 442-447. https://doi.org/10.11648/j.ajp.20200604.19

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    ACS Style

    Ni Made Reditya Noviyani; Ida Bagus Gede Suparyatha; Dyah Kanya Wati; I Nyoman Budi Hartawan. Outcome Comparison Between Pulmonary and Extrapulmonary Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit. Am. J. Pediatr. 2020, 6(4), 442-447. doi: 10.11648/j.ajp.20200604.19

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    AMA Style

    Ni Made Reditya Noviyani, Ida Bagus Gede Suparyatha, Dyah Kanya Wati, I Nyoman Budi Hartawan. Outcome Comparison Between Pulmonary and Extrapulmonary Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit. Am J Pediatr. 2020;6(4):442-447. doi: 10.11648/j.ajp.20200604.19

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  • @article{10.11648/j.ajp.20200604.19,
      author = {Ni Made Reditya Noviyani and Ida Bagus Gede Suparyatha and Dyah Kanya Wati and I Nyoman Budi Hartawan},
      title = {Outcome Comparison Between Pulmonary and Extrapulmonary Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {4},
      pages = {442-447},
      doi = {10.11648/j.ajp.20200604.19},
      url = {https://doi.org/10.11648/j.ajp.20200604.19},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajp.20200604.19},
      abstract = {Acute respiratory distress syndrome (ARDS) is a lung disease characterized by severe diffuse inflammation and hypoxemia. The cause of ARDS can be pulmonary or extrapulmonary originated. The outcome of pulmonary and extrapulmonary pediatric ARDS are poorly described. The objective of this study was to determine the outcome differences between pulmonary and extrapulmonary pediatric ARDS. A retrospective study was carried out in 60 patients who admitted to the Pediatric Intensive Care Unit (PICU), Sanglah Hospital, between January 2018 until December 2019. All children aged 0-18 years old diagnosed with ARDS according to Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria were included in this study. Length of ventilation, ventilator-free days, PICU length of stay, and PICU mortality as the outcome of this study were obtained from medical records. Statistical analysis was done using Chi-square and Mann-Whitney test. Most of the patients were supported by invasive ventilation with the severity of ARDS was mild to moderate. The underlying disease of pulmonary ARDS (ARDSp) was pneumonia (100%), whereas in extrapulmonary ARDS (ARDSexp) was sepsis (100%). Analysis of outcome showed significant difference in mortality (33.3% vs 73.3%, p=0.002). The mortality was higher among those in the moderate severity of oxygenation index (64.5%, p=0.001). No significant difference was found in length of ventilation and PICU length of stay. The ventilator-free days in ARDSp was higher (22 days vs 0 days, p=0.000) compared with the ARDSexp. This study concluded that patients with extrapulmonary ARDS had poorer outcomes (higher mortality and less ventilator-free day) compared with pulmonary ARDS. The severity of ARDS based on the oxygenation index measurement can be used to discriminate mortality.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Outcome Comparison Between Pulmonary and Extrapulmonary Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit
    AU  - Ni Made Reditya Noviyani
    AU  - Ida Bagus Gede Suparyatha
    AU  - Dyah Kanya Wati
    AU  - I Nyoman Budi Hartawan
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    DO  - 10.11648/j.ajp.20200604.19
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    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    EP  - 447
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20200604.19
    AB  - Acute respiratory distress syndrome (ARDS) is a lung disease characterized by severe diffuse inflammation and hypoxemia. The cause of ARDS can be pulmonary or extrapulmonary originated. The outcome of pulmonary and extrapulmonary pediatric ARDS are poorly described. The objective of this study was to determine the outcome differences between pulmonary and extrapulmonary pediatric ARDS. A retrospective study was carried out in 60 patients who admitted to the Pediatric Intensive Care Unit (PICU), Sanglah Hospital, between January 2018 until December 2019. All children aged 0-18 years old diagnosed with ARDS according to Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria were included in this study. Length of ventilation, ventilator-free days, PICU length of stay, and PICU mortality as the outcome of this study were obtained from medical records. Statistical analysis was done using Chi-square and Mann-Whitney test. Most of the patients were supported by invasive ventilation with the severity of ARDS was mild to moderate. The underlying disease of pulmonary ARDS (ARDSp) was pneumonia (100%), whereas in extrapulmonary ARDS (ARDSexp) was sepsis (100%). Analysis of outcome showed significant difference in mortality (33.3% vs 73.3%, p=0.002). The mortality was higher among those in the moderate severity of oxygenation index (64.5%, p=0.001). No significant difference was found in length of ventilation and PICU length of stay. The ventilator-free days in ARDSp was higher (22 days vs 0 days, p=0.000) compared with the ARDSexp. This study concluded that patients with extrapulmonary ARDS had poorer outcomes (higher mortality and less ventilator-free day) compared with pulmonary ARDS. The severity of ARDS based on the oxygenation index measurement can be used to discriminate mortality.
    VL  - 6
    IS  - 4
    ER  - 

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