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Incidence and short-term outcome of acute lung injury in mechanically ventilated children

¹ Dept of Paediatrics, Emma Children's Hospital, and ² Dept of Clinical Epidemiology and Biostatistics, Academic Medical Centre of the University of Amsterdam, Amsterdam, the Netherlands.

CORRESPONDENCE: P. Dahlem, Paediatric Intensive Care Unit, Academic Medical Centre of the University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands. Fax: 31 206919338. E-mail: P.Dahlem@amc.uva.nl

Keywords: acute respiratory distress syndrome, child, epidemiology, mechanical ventilation

Received: January 11, 2003
Accepted August 19, 2003

The aim of this study was to determine the incidence and short-term outcome of mechanically ventilated children suffering from acute lung injury (ALI) on a paediatric intensive care unit (PICU).

Between January 1 1998 and January 1 2000, all mechanically ventilated children were evaluated using the criteria of an American-European Consensus Conference.

Of the 443 children eligible for analysis, 44 (9.9%) were diagnosed as suffering from ALI. Of these, 79.5% developed the acute respiratory distress syndrome (ARDS); 54.5% (24 of 44) fulfilled the ARDS criteria at inclusion and 25% (11 of 44) later. PICU mortality for ALI was 27.3% (12 of 44) and within the ARDS subgroup 31.4% (11 of 35). Of the 12 children who died, 11 had ARDS; the main cause of death was cerebral damage (seven of 12).

Acute lung injury and acute respiratory distress syndrome are rare diseases on apaediatric intensive care unit with a high mortality. Most of the children with acutelung injury develop acute respiratory distress syndrome. In the acute respiratory distress syndrome subgroup, mortality is higher than in the acute lung injury nonacute respiratory distress syndrome subgroup. Further investigations should confirm prognostic factors (e.g. respiratory parameters) for prediction of outcome.

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