Experience with a clinical criteria for the eary diagnosis of Acute respiratory distress syndrome in children

Abstract

In order to evaluate whether “Lung injury score (LIS)” and “criteria for Acute lung injury (ALI) and Acute respiratory distress syndrome (ARDS)” are adequate definitions for early diagnosis in children with ARDS, we performed clinical studies in ARDS group (n=7) and non-ARDS group (n=12). On study of LIS, the time to appear the alteration on each parameter differed and PaO₂/FiO₂ ratio reflected lung injury most sensitively. We compared arterial blood gas analysis between ARDS group and non-ARDS group before the diagnosis, PaO₂/FiO₂ ratio is significantly lower in ARDS group compared with it in non-ARDS group. There were no significant differences between groups in PaCO₂. Early phase of ARDS showed strong hypoxemia against mild hypoventilation supposed by normal level of PaCO₂. We concluded that we can use “LIS” as a final diagnosis and “criteria for ALI and ARDS” as an early diagnosis in children with ARDS. Further investigation on pediatric ARDS, considering the anatomical and physiological characteristics of children, is expected so that we can manage the better mechanical ventilation.