Epidemiology and Outcomes of Acute Respiratory Distress Syndrome in Children According to the Berlin Definition: A Multicenter Prospective Study

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author BARREIRA, Eliane R. FMUSP-HC
MUNOZ, Gabriela O. C. FMUSP-HC
CAVALHEIRO, Priscilla O. FMUSP-HC
SUZUKI, Adriana S. FMUSP-HC
DEGASPARE, Natalia V. FMUSP-HC
SHIEH, Huei H. FMUSP-HC
MARTINES, Joao A. D. S.
FERREIRA, Juliana C. FMUSP-HC
LANE, Christianne
CARVALHO, Werther B. FMUSP-HC
GILIO, Alfredo E. FMUSP-HC
PRECIOSO, Alexander R. FMUSP-HC
dc.date.issued 2015
dc.identifier.citation CRITICAL CARE MEDICINE, v.43, n.5, p.947-953, 2015
dc.identifier.issn 0090-3493
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/9847
dc.description.abstract Objectives: In 2012, a new acute respiratory distress syndrome definition was proposed for adult patients. It was later validated for infants and toddlers. Our objective was to evaluate the prevalence, outcomes, and risk factors associated with acute respiratory distress syndrome in children up to 15 years according to the Berlin definition. Design: A prospective, multicenter observational study from March to September 2013. Setting: Seventy-seven PICU beds in eight centers: two private hospitals and six public academic hospitals in Brazil. Patients: All children aged 1 month to 15 years admitted to the participating PICUs in the study period. Interventions: None. Measurements and Main Results: All children admitted to the PICUs were daily evaluated for the presence of acute respiratory distress syndrome according to the American-European - Consensus Conference and Berlin definitions. Of the 562 patients included, acute respiratory distress syndrome developed in 57 patients (10%) and 58 patients (10.3%) according to the Berlin definition and the American-European Consensus Conference definition, respectively. Among patients with acute respiratory distress syndrome according to the Berlin definition, nine patients (16%) were mild, 21 (37%) were moderate, and 27 (47%) were severe. Compared with patients without acute respiratory distress syndrome, patients with acute respiratory distress syndrome had significantly higher severity scores, longer PICU and hospital length of stay, longer duration of mechanical ventilation, and higher mortality (p < 0.001). The presence of two or more comorbidities and admission for medical reasons were associated with development of acute respiratory distress syndrome. Comparisons across the three the Berlin categories showed significant differences in the number of ventilator-free days (21, 20, and 5 d, p = 0.001) and mortality for severe acute respiratory distress syndrome (41%) in comparison with mild (0) and moderate (15%) acute respiratory distress syndrome(p = 0.02). No differences in PICU or hospital stay were observed across the groups. Conclusions: The Berlin definition can identify a subgroup of patients with distinctly worse outcomes, as shown by the increased mortality and reduced number of ventilator-free days in pediatric patients with severe acute respiratory distress syndrome.
dc.description.sponsorship · FAPESP (Brazilian government agency)
· Fundacao de Amparo a Pesquisa do Estado de Sao Paulo-a Brazilian government agency (FAPESP)
dc.language.iso eng
dc.publisher LIPPINCOTT WILLIAMS & WILKINS
dc.relation.ispartof Critical Care Medicine
dc.rights restrictedAccess
dc.subject critical care; epidemiology; pediatrics; respiration, artificial; respiratory distress syndrome, adults; respiratory insufficiency
dc.subject.other acute lung injury; pediatric intensive-care; consensus; mortality; validate; failure; ards
dc.title Epidemiology and Outcomes of Acute Respiratory Distress Syndrome in Children According to the Berlin Definition: A Multicenter Prospective Study
dc.type article
dc.rights.holder Copyright LIPPINCOTT WILLIAMS & WILKINS
dc.contributor.groupauthor Brazilian Pediat Acute Resp
dc.description.group LIM/09
dc.description.group LIM/36
dc.identifier.doi 10.1097/CCM.0000000000000866
dc.identifier.pmid 25654173
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author BARREIRA, Eliane R.:FM:
hcfmusp.author MUNOZ, Gabriela O. C.:HC:ICR
hcfmusp.author CAVALHEIRO, Priscilla O.:HC:ICR
hcfmusp.author SUZUKI, Adriana S.:HC:ICR
hcfmusp.author DEGASPARE, Natalia V.:HC:ICR
hcfmusp.author SHIEH, Huei H.:HU:DVCLPED-62
hcfmusp.author FERREIRA, Juliana C.:HC:LIM/09
hcfmusp.author CARVALHO, Werther B.:FM:MPE
hcfmusp.author GILIO, Alfredo E.:FM:MPE
hcfmusp.author PRECIOSO, Alexander R.:HC:ICR
hcfmusp.author.external · MARTINES, Joao A. D. S.:Univ Sao Paulo, Div Radiol, Univ Hosp, Sao Paulo, Brazil
· LANE, Christianne:Univ So Calif, Keck Sch Med, Prevent Med, Div Biostat, Los Angeles, CA 90033 USA
hcfmusp.origem.id WOS:000353061000019
hcfmusp.origem.id 2-s2.0-84922382209
hcfmusp.publisher.city PHILADELPHIA
hcfmusp.publisher.country USA
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dc.description.index MEDLINE
dc.identifier.eissn 1530-0293
hcfmusp.citation.wos 17
hcfmusp.affiliation.country Brasil
hcfmusp.affiliation.country Estados Unidos


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