P0439 / #2139: INCIDENCE AND OUTCOME OF PEDIATRIC ARDS: RETROSPECTIVE COMPARAISON BETWEEN THE BERLIN DEFINITION AND THE PALICC CRITERIA

Abstract

Aims & Objectives: Aim was to compare incidence and outcomes of pediatric acute respiratory distress syndrome (pARDS) according to Berlin definitions and Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria. Methods: Data of all admitted patients (1 month to 14 years) to our Pediatric Intensive Care Unit over a 30-months period (July 2017–Dec 2019) were reviewed for presence of any respiratory distress at admission or during PICU stay. Patients with significant cardiac L-R shunt were excluded. PALICC and Berlin criteria were retrospectively applied to these patients. Collected data including criteria, severity and outcom. Patients was classified in 2 groups: the “PALICC only group” and the “Berlin with or without PALICC”. Results: A total of 568 admissions was recorded during the study period: Among them, 359 (63%) were identified had respiratory distress at admission or during PICU stay. A total of 87 childrens (15,3%; 95%) fulfilled definition of pARDS with either of the two PALICC and BERLIN criteria. 81 children (93,1%) fulfilled PALICC criteria and only 47 childrens (54%) fulfilled BERLIN definition. Statistical Agreement between two definitions was moderate (Kappa: 0,59; 95%, observed agreement 88%). More patients had severe ARDS in the “Berlin with or without PALICC group” as compared to the “PALICC only” group (61,7% vs. 25,2%). There was no difference regarding the duration of mechanical ventilation (8 vs. 10 days) but there was a non trend to increased mortality in the BERLIN group [36,1% vs. 22,1%). Conclusions: Compared to the Berlin definition, PALICC criteria seems to identify more patients with pARDS with more severe severity in “Berlin with or without PALICC” group with no difference in outcome.