Factors associated with oxygenation improvement in children with ARDS

Main Article Content

Abdul Chairy
Nurnaningsih Nurnaningsih
Endy P. Prawirohartono


Background In pediatric patients, acute respiratory distress
syndrome (ARDS) has a high mortality rate of approximately
25%. In surviving children, ARDS may result in sequelae, such
as restrictive or obstructive lung dysfunction, muscle weakness
and hypotrophy, as well as psychiatric, intelligence, and memory
Objective To identify prognostic factors related to oxygenation
improvement in children with ARDS.
Methods We conducted a prospective cohort study in the pediatric
intensive care unit (PICU) ofSardjito Hospital, Yogyakarta.
We included 20 children aged 29 days to 18 years who fulfilled the
ARDS criteria. They underwent lung recruitment maneuver for
1 hour. Logistic regression analysis was used to assess for possible
associations between potential prognostic factors and oxygenation
Results None of the subjec ts had significant hemodynamic
changes or hypercapnea during lung recruitment. Two prognostic
factors from our univariate analysis, namely type of ARDS (RR
0.17; 95% CI 0.023 to 1.23; P= 0.079) and severity of ARDS
(RR 0.74; 95% CI 0.007 to 0.84) , were analyzed by multivariate
logression test. However, the results were not statistically
significant for type of ARDS (RR 0.33; 95% CI0.009 to 1.41) or
severity of ARDS (RR 0.11; 95%CI 0.009-3.25).
Conclusion We do not identify any prognostic factors, including
type and severity of ARDS, associated with oxygenation
improvement in children with ARDS.

Article Details

How to Cite
Chairy A, Nurnaningsih N, Prawirohartono E. Factors associated with oxygenation improvement in children with ARDS. PI [Internet]. 28Feb.2014 [cited 17Feb.2020];54(1):42-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/203
Received 2016-08-16
Accepted 2016-08-16
Published 2014-02-28


1. Fiser D. Adult respiratory distress syndrome. Pediatr Rev. 1993;14:163-6.
2. Dahlem P, van Aalderen WM, Hamaker ME, Dijkgraaf MG, Bos AP. Incidence and short-term outcome of acute lung injury in mechanically ventilated children. Eur Respir J. 2003;22:980-5.
3. Herridge MS, Cheung AM, Tansey CM, Matte -Martyn A, Diaz-Granados N, Al-Saidi F, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348:683-93.
4. Hopkins RO, Weaver LK, Pope D, Orme JF, Bigler ED, Larson-Lohr V. Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. Am J Respir Crit Care Med. 1999;160:50-6.
5. Pradhan P, Noviski N. Pediatric acute hypoxemic respiratory failure: management of oxygenation. J Intensive Care Med. 2004;19:140-53.
6. Carpenter T. Novel approaches in conventional mechanical ventilation for paediatric acute lung injury. Paediatr Respir Rev. 2004;5:231-37.
7. Albuali WH, Singh RN, Fraser DD, Seabrook JA, Kavanagh BP, Parshuram CS, et al. Have changes in ventilator practices improved outcome in children with acute lung injury? Pediatr Crit Care Med. 2007;8:324-30.
8. Wahr JA, Lau W, Tremper KK, Hallock L, Smith K. Accuracy and precision of a new, portable, handheld blood gas analyzer, the IRMA. J Clin Monit. 1996;12:317-24.
9. Gattinoni L, Pelosi P, Suter PM, Pedoto A, Vercesi P, Lissoni A. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes? Am J Respir Crit Care Med. 1998; 158:3-11.
10. Lim CM, Jung H, Koh Y, Lee JS, Shim TS, Lee SD, et al. Effect of alveolar recruitment maneuver in early acute respiratory distress syndrome according to antiderecruitment strategy, etiological category of diffuse lung injury, and body position of the patient. Crit Care Med. 2003;31:411-8.
11. Callister MA, Evans TW Pulmonary versus extrapulmonary acute respiratory distress syndrome: different dis eases or just a us eful concept? Curr Opin Crit Care. 2002;8:21-5.
12. Thille AW, Richard JC, Maggiore SM, Ranieri VM, Brochard L. Alveolar recruitment in pulmonary and extrapulmonary acute respiratory distress syndrome: comparison using pressure-volume curve or static compliance. Anesthesiology. 2007;106:212-7.
13. ARDS Definition Task Force, Raniere VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA. 2012;307:2526-33.
14. Boriosi JP, Sapru A, Hanson JH, Asselin J, Gildengorin G, Newman V, et al. Efficacy and safety of lung recruitment in pediatric patients with acute lung injury. Pediatr Crit Care Med. 2011;12:431-6.
15. Steinberg KP, Hudson LD, Goodman RB, Hough CL, Lanken PN, Hyzy R, et al. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med. 2006;354:1671-84.