Allergy, Asthma & Respiratory Disease

The Korean Academy of Asthma, Allergy and Clinical Immunology (대한천식알레르기학회)
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Characteristics and prognostic factors of previously healthy children who required respiratory support in a pediatric intensive care unit

만성 병력 없이 호흡보조를 위해 중환자실에 입원한 소아의 특성 및 예후인자

  • Jung, Minyoung (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Minji (Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University School of Medicine) ;
  • Lee, Ok Jeong (Department of Pediatrics, Myongji Hospital, Seonam University College of Medicine) ;
  • Choi, Ah Young (Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hwang, Taewoong (Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cho, Joongbum (Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 정민영 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 김민지 (한림대학교 의과대학 동탄성심병원 소아청소년과) ;
  • 이옥정 (서남대학교 의과대학 명지병원 소아청소년과) ;
  • 최아영 (성균관대학교 의과대학 삼성서울병원 중환자의학과) ;
  • 황태웅 (성균관대학교 의과대학 삼성서울병원 중환자의학과) ;
  • 조중범 (성균관대학교 의과대학 삼성서울병원 중환자의학과)
  • Received : 2017.07.03
  • Accepted : 2017.08.23
  • Published : 2018.03.31
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Abstract

Purpose: Comorbidities have been considered a mortality risk factor in pediatric critical care patients. We studied the characteristics and prognostic factors of children without comorbidities who were admitted to the intensive care unit (ICU) due to respiratory failure. Methods: We reviewed the medical charts of patients (<18 years) admitted to the ICU for respiratory support in a single tertiary center between January 2006 and December 2016. Patients with comorbidities and perioperative statuses were excluded. Results: Of the 4,712 ICU patients, 73 (1.5%) were included in this study. The median age was 31 months (8-57) and 51 (69.9%) were boys. Twenty-nine patients (39.7%) presented with pneumonia, 14 (19.2%) with acute respiratory distress syndrome (ARDS), and 11 (15.1%) with obstructive airway disease. The median duration of ICU hospitalization was 5 days (2-14.5), and 45 of the 73 patients (61.6%) needed mechanical ventilation. Mortality was 13.7% (10/73). None of the patients with pneumonia or obstructive airway disease died. The most frequent cause of death was ARDS (5 of 10, 50%). In adjusted analysis, the extent of extrapulmonary organ dysfunction was significantly associated with mortality (odds ratio, 2.89; 95% confidence interval, 1.17-7.11; P= 0.023). Conclusion: The mortality rate of previously healthy pediatric patients needing respiratory support in the ICU should not be negligible. Multiple organ dysfunctions might be a significant risk factor for mortality in such patients.

Keywords

References

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