title: The epidemiology of acute respiratory distress syndrome in pediatric intensive care units in China.
abstract: OBJECTIVE
  To assess the incidence of, predisposing factors for, and the rates and relative risks of mortality from acute respiratory distress syndrome (ARDS) in pediatric patients.
  
  
  METHODS
  A prospective study in 12 consecutive months from 2004 to 2005 in 25 pediatric intensive care units (PICUs).
  
  
  METHODS
  ARDS was diagnosed according to the 1994 American-European Consensus Conference definitions, applied to all severely ill admissions between 1 month and 14 years of age. The PICUs were in major municipalities and provincial cities, and half were university affiliated.
  
  
  RESULTS
  From a total of 12,018 admissions, 7,269 were severely ill. One hundred and five (1.44%) patients developed ARDS and 64 (61.0%) died, which accounts for 13.2%, of the total ICU death (n = 485, 6.7%) or a nine times relative risk of dying. The median age at onset of ARDS was 24 months and 40% were less than 12 month old. Median time from PICU admission to the onset of ARDS was 16 h, and in 63% <24 h. Pneumonia (55.2%) and sepsis (22.9%) were the major predisposing factors for ARDS. These were respectively 14 and 5 times as high a death rate as those of the severely ill patients without ARDS.
  
  
  CONCLUSIONS
  ARDS has a high mortality in these Chinese PICUs, especially in those with pneumonia and sepsis, and adequate management including lung protective ventilation strategy is required.
authors.affiliation: Children's Hospital of Fudan University, 183 Feng Lin Road, 200032, Shanghai, People's Republic of China.
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Yu
authors.forename: Zhu-Jin
authors.initials: ZJ
authors.lastname: Lu
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Shi
authors.forename: Feng-Wu
authors.initials: FW
authors.lastname: Kuang
authors.forename: Su-Yun
authors.initials: SY
authors.lastname: Qian
authors.forename: Qi-Yi
authors.initials: QY
authors.lastname: Zeng
authors.forename: Min-Hui
authors.initials: MH
authors.lastname: Xie
authors.forename: Guo-Ying
authors.initials: GY
authors.lastname: Zhang
authors.forename: De-Yi
authors.initials: DY
authors.lastname: Zhuang
authors.forename: Xun-Mei
authors.initials: XM
authors.lastname: Fan
authors.forename: Bo
authors.initials: B
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008171:Lung Diseases / Q000401:mortality* / Q000628:therapy; D008297:Male; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D018805:Sepsis / Q000150:complications / Q000453:epidemiology; D013577:Syndrome