Acute lung injury in pediatric intensive care in Australia and New Zealand: a prospective, multicenter, observational study

Erickson, Simon, Schibler, Andreas, Numa, Andrew, Nuthall, Gabrielle, Yung, Michael, Pascoe, Elaine, Wilkins, Barry and Paediatric Study Group (2007) Acute lung injury in pediatric intensive care in Australia and New Zealand: a prospective, multicenter, observational study. Pediatric Critical Care Medicine, 8 4: 317-323.


Author Erickson, Simon
Schibler, Andreas
Numa, Andrew
Nuthall, Gabrielle
Yung, Michael
Pascoe, Elaine
Wilkins, Barry
Paediatric Study Group
Title Acute lung injury in pediatric intensive care in Australia and New Zealand: a prospective, multicenter, observational study
Journal name Pediatric Critical Care Medicine   Check publisher's open access policy
ISSN 1529-7535
1947-3893
Publication date 2007-07
Sub-type Article (original research)
DOI 10.1097/01.PCC.0000269408.64179.FF
Volume 8
Issue 4
Start page 317
End page 323
Total pages 7
Place of publication Baltimore, MD, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract Objective: Acute lung injury (ALI) is poorly defined in children. The objective of this prospective study was to clarify the incidence, demographics, management strategies, outcome, and mortality predictors of ALI in children in Australia and New Zealand.
Design: Multicenter prospective study during a 12-month period.
Setting: Intensive care unit.
Patients: All children admitted to intensive care and requiring mechanical ventilation were screened daily for development of ALI based on American-European Consensus Conference guidelines. Identified patients were followed for 28 days or until death or discharge.
Interventions: None.
Measurements and Main Results: There were 117 cases of ALI during the study period, giving a population incidence of 2.95/100,000 <16 yrs. ALI accounted for 2.2% of pediatric intensive care unit admissions. Mortality was 35% for ALI, and this accounted for 30% of all pediatric intensive care unit deaths during the study period. Significant preadmission risk factors for mortality were chronic disease, older age, and immunosuppression. Predictors of mortality during admission were ventilatory requirements (peak inspiratory pressures, mean airway pressure, positive end-expiratory pressure) and indexes of respiratory severity on day 1 (Pao2/Fio2 ratio and oxygenation index). Higher maximum and median tidal volumes were associated with reduced mortality, even when corrected for severity of lung disease. Development of single and multiple organ failure was significantly associated with mortality.
Conclusions: ALI in children is uncommon but has a high mortality rate. Risk factors for mortality are easily identified. Ventilatory variables and indexes of lung severity were significantly associated with mortality.
Keyword Acute lung injury
Acute respiratory distress syndrome
Ventilation
Pediatric
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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