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Pediatría (Asunción)

On-line version ISSN 1683-9803


OMAR EUGENIO, Naveda Romero  and  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.


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.


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.


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).


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.

Keywords : Acute respiratory distress syndrome; risk factors; children..

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