title: [Risk factors for acute respiratory distress syndrome following surgeries for pediatric critical and complex congenital heart disease].
abstract: OBJECTIVE
  To explore the risk factors for acute respiratory distress syndrome (ARDS) in children receiving surgeries for critical and complex congenital heart disease (CCHD).
  
  
  METHODS
  According to the 2011's Berlin definition of ARDS, the clinical data were collected from 75 children without ARDS (group I) and 80 children with ARDS (group II) following surgeries for CCHD performed in the Department of Cardiac Surgery of our hospital from January, 2009 to May, 2014. Univariate analyses and logistic regression were used to analyze the risk factors contributing to the occurrence of ARDS following the surgeries.
  
  
  RESULTS
  In the 80 patients who developed ARDS postoperatively in group II, 27 had mild ARDS, 25 had moderate ARDS, and 28 had severe ARDS; death occurred in 17 (21%) cases. Univariate analyses showed that 23 parameters were significantly different between groups I and II (P<0.05), including weight; preoperative PCO2, left ventricular ejection fraction, pulmonary artery pressure, pulmonary infection, and coagulation abnormalities; early postoperative serum globulin; intraoperative aortic cross clamp (ACC) time; cardiopulmonary bypass (CPB) time; operation time; blood loss and blood transfusion amount intraoperatively and during the first 8 h after operation; lactic acid level immediately after the operation and its maximum increasing rate within 24 h postoperatively; postoperative serum levels of albumin and creatinine; serum levels of B-type natriuretic peptide, procalcitonin, C-reactive protein, and prealbumin 24 h after operation; and age. Logistic regression analyses showed that intraoperative ACC time, CPB time, the maximum increasing rate of lactic acid within 24 h after operation, serum procalcitonin 24 h after operation and intraoperative blood loss were independent risk factors for postoperative ARDS.
  
  
  CONCLUSIONS
  The risk factors of ARDS identified in these children can predict the occurrence of ARDS following the surgeries and timely interventions can improve the success rate in treatment of postoperative ARDS in children with CCHD.
authors.affiliation: Third Department of Critical Care Medicine, Provincial Clinical College of Fujian Medical University/Fujian Provincial Hospital, Fuzhou 350001, China. E-mail: m15060677447@163.com.
authors.forename: Shu-Rong
authors.initials: SR
authors.lastname: Gong
authors.forename: Ying-Rui
authors.initials: YR
authors.lastname: Zhang
authors.forename: Rong-Guo
authors.initials: RG
authors.lastname: Yu
mesh_terms: D002097:C-Reactive Protein; D002116:Calcitonin; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D006331:Heart Diseases / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D020097:Natriuretic Peptide, Brain; D012131:Respiratory Insufficiency / Q000209:etiology*; D012307:Risk Factors
chemical_list: D020097:Natriuretic Peptide, Brain; D002116:Calcitonin; D002097:C-Reactive Protein