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Year : 2023  |  Volume : 23  |  Issue : 2  |  Page : 96-103

Sepsis-related pediatric acute respiratory distress syndrome: A multicenter prospective cohort study

1 Department of Pediatrics, Division of Pediatric Pulmonology and Critical Care Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
2 Department of Pediatrics, Division of Pediatric Critical Care, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
3 Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
4 Department of Pediatrics, Nakornping Hospital, Chiang Mai, Thailand
5 Department of Pediatrics, Division of Pediatric Critical Care, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

Correspondence Address:
Nattachai Anantasit
Department of Pediatrics, Division of Pediatric Critical Care, Ramathibodi Hospital, 270 Rama VI Road, Ratchathewee, Bangkok 10400
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjem.tjem_237_22

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OBJECTIVES: This study aimed to compare the risk factors and outcomes for organ dysfunction between sepsis-related Pediatric acute respiratory distress syndrome (PARDS) and nonsepsis PARDS. METHODS: We prospective cohort recruited intubated patients with PARDS at four tertiary care centers in Thailand. The baseline characteristics, mechanical ventilation, fluid balance, and clinical outcomes were collected. The primary outcome was organ dysfunction. RESULTS: One hundred and thirty-two mechanically ventilated children with PARDS were included in the study. The median age was 29 months and 53.8% were male. The mortality rate was 22.7% and organ dysfunction was 45.4%. There were 26 (19.7%) and 106 (80.3%) patients who were classified into sepsis-related PARDS and nonsepsis PARDS, respectively. Sepsis-related PARDS patients had a significantly higher incidence of acute kidney injury (30.8% vs. 13.2%, P = 0.041), septic shock (88.5% vs. 32.1%, P < 0.001), organ dysfunction (84.6% vs. 35.8%, P < 0.001), and death (42.3% vs. 17.9%, P = 0.016) than nonsepsis PARDS group. Multivariate analysis adjusted for clinical variables showed that sepsis-related PARDS and percentage of fluid overload were significantly associated with organ dysfunction (odds ratio [OR] 11.414; 95% confidence interval [CI] 1.40892.557, P = 0.023 and OR 1.169; 95% CI 1.0121.352, P = 0.034). CONCLUSIONS: Sepsis-related PARDS patients had more severe illness, organ dysfunction, and mortality than nonsepsis PARDS patients. The higher percentage of fluid overload and presentation of sepsis was the independent risk factor of organ dysfunction in PARDS patients.

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