Long-term assessment of pulmonary function tests in pediatric survivors of acute respiratory distress syndrome
Gideon Paret, Zohar Barzilay, Osnat Moreh, Ran Harel, Ron Ben-Abraham, Avi A Weinbroum, Arie Augarten, Ori Efrati, Hector Roizin
Med Sci Monit 2002; 8(3): CR153-157
Available online: 2002-03-11
BACKGROUND: The aim of the study was to evaluate long-term pulmonary functiontests in pediatric survivors of acute respiratory distress syndrome (ARDS). MATERIAL/METHODS: Observationalstudy based on a telephone poll of retrospectively identified post ARDS children who were hospitalizedin a pediatric intensive care unit (PICU) in a general 1200-bed teaching, tertiary, regional referralcenter for children. RESULTS: Follow-up pulmonary function tests were achieved in only 7 children, witha mean age of 7.3±4.3 years (range 3-12) and following 5.6±4.3 years after PICU discharge. The etiologyfor ARDS included: lymphoma (n=2), pneumonia (n=2), aspiration (n=1), petrol ingestion (n=1) and snakeenvenomation (n=1). The children had been ventilated for 9.4±7.3 days and their worst PaO2/FiO2 ratiowas 65.1±17.0 mm Hg. The follow-up pulmonary functions in all the children was within normal limitsexcept for one child who had mildly reduced DLCO and one who had mild exercise-induced hypoxemia (oxyhemoglobinsaturation of 94%). Neither of the two nor the others showed subjective symptoms or clinical physicallimitations. CONCLUSIONS: Children who survive ARDS apparently enjoy long-term normal pulmonary function.Some, however, may present subclinical dysfunction that persists for many years after the acute episodeand evoked only by sophisticated lung tests.
Keywords: Child, Child, Preschool, Infant, Newborn, Prognosis, Respiratory Distress Syndrome, Newborn, Respiratory Function Tests