Factors associated with oxygenation improvement in children with ARDS

Abdul Chairy; Nurnaningsih Nurnaningsih; Endy P. Prawirohartono

doi:10.14238/pi54.1.2014.42-5

Abdul Chairy Department of Child Health, Universitas Gadjah Mada Medical School ;Sardjito General Hospital
Nurnaningsih Nurnaningsih Department of Child Health, Universitas Gadjah Mada Medical School ;Sardjito General Hospital
Endy P. Prawirohartono Department of Child Health, Universitas Gadjah Mada Medical School ;Sardjito General Hospital

DOI: https://doi.org/10.14238/pi54.1.2014.42-5

Keywords: ARDS, oxygenation improvement

Abstract

Background In pediatric patients, acute respiratory distress
syndrome (ARDS) has a high mortality rate of approximately
25%. In surviving children, ARDS may result in sequelae, such
as restrictive or obstructive lung dysfunction, muscle weakness
and hypotrophy, as well as psychiatric, intelligence, and memory
problems.
Objective To identify prognostic factors related to oxygenation
improvement in children with ARDS.
Methods We conducted a prospective cohort study in the pediatric
intensive care unit (PICU) ofSardjito Hospital, Yogyakarta.
We included 20 children aged 29 days to 18 years who fulfilled the
ARDS criteria. They underwent lung recruitment maneuver for
1 hour. Logistic regression analysis was used to assess for possible
associations between potential prognostic factors and oxygenation
improvement.
Results None of the subjec ts had significant hemodynamic
changes or hypercapnea during lung recruitment. Two prognostic
factors from our univariate analysis, namely type of ARDS (RR
0.17; 95% CI 0.023 to 1.23; P= 0.079) and severity of ARDS
(RR 0.74; 95% CI 0.007 to 0.84) , were analyzed by multivariate
logression test. However, the results were not statistically
significant for type of ARDS (RR 0.33; 95% CI0.009 to 1.41) or
severity of ARDS (RR 0.11; 95%CI 0.009-3.25).
Conclusion We do not identify any prognostic factors, including
type and severity of ARDS, associated with oxygenation
improvement in children with ARDS.

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