Abstract P-610: EPIDEMIOLOGY OF PAEDIATRIC ACUTE RESPIRATORY DISTRESS SYNDROME IN A SINGLE CENTRE IN SINGAPORE

Abstract

Aims & Objectives: Paediatric acute respiratory distress syndrome (PARDS) is a severe and rapid onset of lung injury associated with significantly increased mortality and morbidity. We aim to describe the epidemiology and outcomes of PARDS in our centre. Methods This retrospective study identified patients admitted to the Paediatric Intensive Care Unit (PICU) during years 2010–2015 who fulfilled the Paediatric Lung Injury Consensus Conference criteria for PARDS. Data on demographics, management strategies and detailed mechanical ventilation and blood gas parameters over first 7 days of PARDS were collected. Primary outcome was PICU mortality. Categorical and continuous variables were presented as counts (percentages) and median (interquartile ranges). Multivariate logistic regression was used to identify factors associated with mortality. Results 162 patients with PARDS were identified. The median age was 3.13(0.93, 9.89) years. The most common risk factor for PARDS was pneumonia [115/162(71%)]. 98(60.5%) patients had chronic comorbidities and 72(44.4%) developed multi organ dysfunction. Overall mortality was 75/162 (46.3%). Majority of patients [93/162(57.4%)] were ventilated on conventional ventilation. 29(17.9%), 58(35.8%) and 53(32.7%) patients were classified respectively under mild, moderate and severe PARDS. 28-day PICU free days and ventilator free days were 19.0 (8.0, 23.3) and 20.0 (10.8, 24.3) days respectively. Presence of comorbidities [adjusted odds ratio, aOR 4.43(95% CI 1.44, 13.66)], severe category of PARDS [aOR 6.43(95%CI 1.16, 35.71)] and multiorgan dysfunction [aOR 5.26(95% CI 1.49, 18.55)] were independently associated with PICU mortality. Conclusions PARDS is associated with high mortality. Independent risk factors include presence of comorbidities, severe category of PARDS and multiorgan dysfunction.