[Pediatric characteristics of adult respiratory distress syndrome: a meta-analysis].
A meta-analysis of the literature is carried out in order to present the current knowledge of ARDS in childhood (0-15 years). This might be helpful for planning controlled studies on new therapeutic measures (e.g. surfactant replacement, antioxidants, extracorporeal gas exchange). By means of Medline all available publications were taken into account referring to minimal criteria defined before. There were 4 studies (50 patients) and 48 individual case-reports (48 patients). Most often ARDS was caused by infection (21 resp. 30%), aspiration (12 resp. 23%) and trauma (10 resp. 23%). Therapeutically high respiration pressures and toxic oxygen tensions were applied generally (average maximum PEEP: 14.7 resp. 15.8 cm H2O; average maximum PIP: 59.6 resp. 61.9 cm H2O; FiO2 > 0.5 for an average of 10.1 resp. 10.4 days). The most frequent complications were barotrauma (43.8 resp. 78%), infection (60.4%) and multiorgan failure (66.7%). Mortality rate was 31.3 resp. 52%. So also in childhood almost every second case is fatal. Especially multiorgan failure as well as high levels of FiO2 and PEEP indicate bad prognosis at an early stage. Therefore it is necessary and justified to perform clinical trials on therapeutic agents successfully tested in animal studies before.
Freund
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Klinik und Poliklinik für Kinderheilkunde, Westfälische Wilhelms-Universität Münster.
Jorch
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G
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D015996:Survival Rate
Kindliche Besonderheiten des ARDS: Eine Metaanalyse.