PURPOSE: Patients with ARDS cause a significant morbidity & mortality. However, little is known about the long term outcomes of Pediatric ARDS. Thus, we decided to evaluate the clinical, functional outcomes and quality of life in survivors of Pediatric ARDS.
METHODS: Infants and children (aged 1 month - 15 years) with diagnosis of ARDS. who were discharged from PICU at King Chulalongkorn Memorial hospital from July, 2006 - December, 2007 were studied. They were followed at 6, 12, 18 months and 24 month after discharged. Their clinical & functional outcomes and quality of life (PedsQL TM) were compared with age, sex matched controlled children.
RESULTS: 794 patients were admitted to PICU during studied period, there were 26 patients diagnosed with ARDS. Of 13 (13/26, 50%) survivors, 12 (11/13, 84.6%) were eligible for the study. The median age was 2.3 years. Most common causes were severe pneumonia and sepsis. The median of initial PaO2/FiO2 was at 106 mHg. The median duration of mechanical ventilator & PICU stay & hospital stay was 18, 19 & 40 days, respectively. All patients reported poor physical function, muscle weakness and fatique at the time of discharged. They returned to their normal growth velocity at 12 months follow-up. 3 cases (3/12, 25%) developed CLD and required supplement oxygen at discharged and one remain on oxygen at 1 year follow-up. Six-minute walk test demonstrated increasing in distance from a median of 338.5 m at 18 months to 430 m at 24 months. Although the six-minute walking distance was lower compared to normal controlled but no statistically significant.
CONCLUSION: Survivors of Pediatric ARDS continue to have functional impairment and compromised health-related quality of life. However, it tended to improve overtime at 1 & 2 year follow-up.
CLINICAL IMPLICATIONS: Pediatric ARDS cause significant functional impairment and reduction in quality of life. Clinicians, health-related personnel and caregivers should be awared of the long-term outcomes and find the way to improve.
DISCLOSURE: Rujipat Samransamruajkit, No Financial Disclosure Information; No Product/Research Disclosure Information