Pediatric trauma-associated acute respiratory distress syndrome: Incidence, risk factors, and outcomes

Space: StayCurrentMD Author: Amory de Roulet, Rita V. Burke, Joanna Lim, Stephanie Papillon, David W. Bliss, Henri R. Ford, Jeffrey S. Upperman, Kenji Inaba, Aaron R. Jensen Published:

Author / Expert

Amory de Roulet, Rita V. Burke, Joanna Lim, Stephanie Papillon, David W. Bliss, Henri R. Ford, Jeffrey S. Upperman, Kenji Inaba, Aaron R. Jensen

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Abstract

Background/Purpose

Acute Respiratory Distress Syndrome (ARDS) results in significant morbidity and mortality in pediatric trauma victims. The objective of this study was to determine risk factors and outcomes specifically related to pediatric trauma-associated ARDS (PT-ARDS).

Methods

A retrospective cohort (2007–2014) of children ≤18 years old from the American College of Surgeons National Trauma Data Bank (NTDB) was used to analyze incidence, risk factors, and outcomes related to PT-ARDS.

Results

PT-ARDS was identified in 0.5% (2660/488,381) of the analysis cohort, with an associated mortality of 18.6% (494/2660). Mortality in patients with PT-ARDS most commonly occurred in the first week after injury. Risk factors associated with the development of PTARDS included nonaccidental trauma, near drowning, severe injury (AIS ≥ 3) to the head or chest, pneumonia, sepsis, thoracotomy, laparotomy, transfusion, and total parenteral nutrition use. After adjustment for age, injury complexity, injury mechanism, and physiologic variables, PT-ARDS was found to be independently associated with higher mortality (adjusted OR 1.33, 95% CI 1.18–1.51, p 

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