Document Detail

FiO2 predicts outcome in infants with respiratory syncytial virus-induced acute respiratory distress syndrome.
MedLine Citation:
PMID:  24347224     Owner:  NLM     Status:  Publisher    
OBJECTIVE: Respiratory syncytial virus (RSV) infection can progress to acute respiratory distress syndrome (ARDS) in infants. ARDS is a life-threatening condition that is characterized by severe hypoxemia, defined as PaO2 /FiO2 ratio <300 mmHg. This ratio is used in many trials as the sole oxygenation criterion for ARDS. Recently, however, it has been shown in adults with ARDS that FiO2 , independently of the PaO2 /FiO2 ratio predicts mortality. Because epidemiology and outcome of ARDS differ strongly between children and adults, we determined if FiO2 on admission (baseline FiO2 ) independently predicted the duration of mechanical ventilation (MV) and length of stay (LOS) in the pediatric intensive care unit (PICU) in infants with RSV-induced ARDS.
DESIGN: Retrospective observational study.
SETTING: A 14-bed pediatric intensive care unit.
PATIENTS: One hundred twenty-nine mechanically ventilated infants with RSV-induced ARDS.
MEASUREMENTS AND MAIN RESULTS: Independent predictors for outcome, including baseline FiO2 and PEEP, were analyzed using the cox regression model. Endpoints were duration of MV and LOS in the PICU. A higher baseline FiO2 was independently associated with a longer duration of MV (HR 0.12, CI 0.02-0.87, P = 0.036) and increased LOS in the PICU (HR 0.09, CI 0.01-0.57, P = 0.023). Neither baseline PEEP nor PaO2 /FiO2 ratio correlated with outcome.
CONCLUSIONS: FiO2 level independently predicted outcome in infants with RSV-induced ARDS, whereas both PEEP and the PaO2 /FiO2 ratio did not. This suggests that FiO2 should be taken into account in defining disease severity in infants with RSV-induced ARDS. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.
Kiry M Schene; Elske van den Berg; Roelie M Wösten-van Asperen; Rick R van Rijn; Albert P Bos; Job B M van Woensel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-17
Journal Detail:
Title:  Pediatric pulmonology     Volume:  -     ISSN:  1099-0496     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 Wiley Periodicals, Inc.
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