High incidence of acute lung injury in children with Down syndrome.
OBJECTIVE
Acute respiratory tract infection is a common reason for hospitalization in children with Down syndrome (CDS) and is characterized by a high morbidity. The severe course of disease in CDS may be related to a higher incidence of acute lung injury (ALI). This study evaluated the incidence of ALI and acute respiratory distress syndrome (ARDS) in mechanically ventilated CDS.


METHODS
Retrospective cohort study in a pediatric ICU.


METHODS
Cases were all mechanically ventilated CDS admitted to our unit between January 1998 and July 2005. All mechanically ventilated patients without Down syndrome from January 1998 to January 2001 served as controls. Postoperative patients (cases and controls) and those with a cardiac left to right shunt were excluded.


RESULTS
The main outcome measure was the incidence of ALI and ARDS. The criteria for ALI were met in 14 of 24 CDS (58.3%) in 41 of 317 of controls (12.9%; OR 9.4, 95% CI 3.9-22.6). The criteria for ARDS were met in 11 of 24 CDS (46%) and in 21 of 317 of controls (7%; OR 11.9, 95% CI 4.8-29.8). None of the CDS with ALI died; in the control group ten patients with ALI died.


CONCLUSIONS
CDS had a significantly higher incidence of ALI and ARDS than children without Down syndrome. The explanation for this remains to be elucidated; further study is necessary before clinical implications become clear.
Emma Children's Hospital, Academic Medical Center, Pediatric Intensive Care Unit, PO Box 22660, 1100 DE Amsterdam, The Netherlands. m.bruijn@amc.uva.nl
M
M
Bruijn
L B
LB
van der Aa
R R
RR
van Rijn
A P
AP
Bos
J B M
JB
van Woensel
D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004314:Down Syndrome / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies