Abstract
Background and Objectives: By now, numerous studied have tried to find prognostic factors in patients with acute lung injury (ALI); however the available data are controversial. The aim of the present study was to determine effective factors of outcome in children with ALI.
Materials and Methods: In an observational cross-sectional study, 64 pediatric patients with ALI were recruited in a 22-month period in Tabriz Children’s Hospital. The pediatric Intensive Care Unit (PICU) outcome was determined and accordingly the patients were allocated in two groups; discharged patients and deceased. Patients’ characteristics including age and gender, underlying disorders, parameters of mechanical ventilations, arterial blood gass, organ involvement, presence of acute respiratory distress syndrome (ARDS) and pediatric risk of mortality (PRISM) score were compared between the two groups.
Results: The PICU mortality rate was 51.6%. Independent predictive factors of mortality were higher (more negative) base excess (BE) higher positive end-expiratory pressure (PEEP) and peak inspiratory pressure (PIP), and higher on-admission PRISM score, as well as presence of other organ involvement and ARDS. Parameters such as age, gender, underlying disorders and length of stay, PaO2 and PaCO2 were not significantly different between the two groups. In multivariate study, however, high PRISM score was the only dependent predictor of mortality (≥13.5, sensitivity: 75.8%, specificity: 90.3%).
Conclusion: The PRISM score was the only reliable predictor of PICU-mortality in pediatric patients with ALI.