[Adult-type respiratory distress syndrome in pediatrics. Apropos of 20 cases].
Twenty cases of adult-type respiratory distress syndrome (ARDS) observed in children aged less than 15 years (excluding neonates) are reported; 55% survived and 45% died. A comparative study of both groups showed that prognosis is not related to the child's condition at the time of admission. On the contrary, evolution during the first 72 hours seems to be of prime importance. Treatment included artificial ventilation with PEEP, the optimal level of which was defined by empirical means; maximal PEEP reached 13.2 +/- 4.7 cmH2O and 20.3 +/- 4 cmH2O in the surviving and the deceased groups, respectively. Maintenance to a steady level was reached by using cuffed endotracheal tubes. No correlation was found between maximal PEEP levels and pneumothorax frequency, the latter being identical in both groups. Cardiac catheterization, performed in 5 cases, was helpful in defining adequate additional therapy which improved hematosis and, when done early, appeared to favorably influence the prognosis.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D011175:Positive-Pressure Respiration; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors
Le syndrome de détresse respiratoire de "type adulte" en pédiatrie. A propos de vingt observations.