P0389 / #794: PEDIATRIC ACUTE RESPIRATORY DISTRESS SYNDROME IN CHILDREN WITH MALIGNANCIES

Abstract

Aims & Objectives: There are limited data regarding the clinical characteristics and outcome of pediatric acute respiratory distress syndrome (PARDS) in children with malignancies. The objectives were to investigate the clinical course and mortality of PARDS in children with malignancies. Methods: This is a retrospective cohort study from 2016-2019 in single pediatric intensive care unit. Only PARDS patients who are transferred from the hematology and oncology department were included. Results: Of Seventy-five included patients, 52 children had hematological malignancies including 10 allogeneic bone-marrow transplants and 23 children had solid tumors. Etiological categories were primary infection-related PARDS(n= 41), extrapulmonary septic shock-related PARDS (n = 29); noninfectious PARDS (n = 5). Eight patients received non-invasive mechanical ventilation (NIV), 22 received invasive mechanical ventilation(MV), and 45 received both NIV and invasive MV. PICU mortality was 82% in the cohort. The presence of two or more organ failures and bone-marrow transplantation were the independent risk factors for mortality, whereas NIV was associated with low mortality. Conclusions: The mortality of PARDS in critically ill children with malignancies is quite high. Multiple organ failure, bone-marrow transplantation, and NIV failure were risk factors for higher mortality.