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Pediatría (Asunción)
versión On-line ISSN 1683-9803
Resumen
OMAR EUGENIO, Naveda Romero y NAVEDA MELENDEZ, Andrea Fabiola. Risk factors for the development of acute respiratory distress syndrome: a case-control study. Pediatr. (Asunción) [online]. 2016, vol.43, n.3, pp.225-231. ISSN 1683-9803. https://doi.org/10.18004/ped.2016.diciembre.225-231.
Introduction:
The acute respiratory distress syndrome (ARDS) is an important cause of acute respiratory failure, is associated with a significant risk of mortality; despite current progress in mechanical ventilation and protective lung ventilation.
Objective:
Determine risk factors for the development of ARDS in children with more than 48 hours of mechanical ventilation.
Materials and Methods:
Was designed a case-control study, where were compared 61 children with ARDS with 183 controls without ARDS with age between 1 month and 15 years. A logistic regression model was created to evaluate the effect on the risk.
Results:
In univariate analysis, the factors associated with ARDS were: PELOD score, pulmonary contusion, multiple trauma, shock, red blood cell transfusion, fluid overload, PaO2/FiO2 ratio, oxygenation index, PEEP and pH. Through binary logistic regression was identified as predictors for the development of ARDS: More than 3 red blood cell transfusions (OR: 1.5; 95% CI 1.2 - 1.9, p = 0.010), fluid overload (OR: 1.3; 95% CI 1.1 - 5.7, p = 0.012) and oxygenation index more than 8 without other criteria for ARDS (OR: 1.9; 95% CI 1.4 - 2.6, p < 0.0001). Mortality was higher in the group with ARDS (37.7% vs. 6.0%, p < 0.0001).
Conclusion:
More than 3 red blood cell transfusions, fluid overload and oxygenation index more than 8 are risk factors for the development of ARDS. Early recognition of risk factors of ARDS could help decrease its development.
Palabras clave : Acute respiratory distress syndrome; risk factors; children..