عوامل مؤثر بر پیش‌آگهی سندرم دیسترس حاد تنفسی در کودکان

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استادیار،گروه کودکان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، کمیته‌ی تحقیقات دانشجویی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: سندرم دیسترس حاد تنفسی (Acute respiratory distress syndrome یا ARDS) با وجود درمان شدید و تهویه‌ی مکانیکی طولانی مدت با مرگ و میر بالا و افت شدید کیفیت زندگی نجات یافتگان همراه است. یافته‌های مطالعات انجام شده در زمینه‌ی پیش‌آگهی این سندرم متناقض بود. از این رو، مطالعه‌ی حاضر جهت تعیین عوامل مؤثر بر سندرم دیسترس تنفسی حاد کودکان طراحی گردید.روش‌ها: در این مطالعه‌ی مقطعی تمام پرونده‌های بیماران بستری در Pediatric intensive care unit (PICU) بیمارستان امام حسین (ع) اصفهان در سال‌های 93-1391 از بایگانی استخراج شد. پرونده‌های بیمارانی که با تشخیص نهایی ARDS وسن 15-15 سال تمام در بخش PICU بستری شده بودند، وارد مطالعه شدند. 88 کودک بر اساس پیش‌آگهی به دو گروه فوت شده و بهبود یافته تقسیم شدند و اطلاعات به دست آمده شامل سن، جنس، بیماری زمینه‌ای، مدت بستری، مشخصات تهویه‌ی مکانیکی، گاز خون شریانی و نمره‌ی Pediatric risk of mortality (PRISM) با استفاده از نرم‌افزار SPSS بین دو گروه مقایسه شد.یافته‌ها: متغیرهای مؤثر در مرگ و میر بیماران شامل نمره‌ی PRISM بالا در بدو پذیرش، Positive end-expiratory pressure (PEEP) بالاتر، Peak inspiratory pressure (PIP) بالاتر و درگیری عضو قلبی- عروقی و کلیوی و وجود ARDS بودند (050/0 > P) و متغیرهای سن، جنس، مدت بستری، وزن، Partial pressures of oxygen (PaO2) و Partial pressure of carbon dioxide (PaCO2) بین دو گروه تفاوت معنی‌دار آماری نداشت (050/0 < P).نتیجه‌گیری: نمره‌ی PRISM در بدو پذیرش، پیش‌بینی کننده‌ی مناسب مرگ و میر در بخش مراقبت‌های ویژه‌ی کودکان می‌باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Prognostic Factors of Outcome in Children with Acute Respiratory Distress Syndrome

نویسندگان [English]

  • Mohsen Reisi 1
  • Mohsen Jari 1
  • Mahdiyeh Sadat Mousavi-Rad 2
1 Assistant Professor, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Available data about the prognostic factors in children with acute respiratory distress syndrome (ARDS) are controversial. The goal of our study was to determine the prognostic factors of outcome in children with ARDS.Methods: In this cross sectional study, 88 children with ARDS in Imam Hossein children hospital, Isfahan, Iran, were recruited in a period of 2 years. According to outcomes, patient allocated into two groups of deceased and discharged. Patients’ characteristics including age and gender, underlying disorders, parameters of mechanical ventilations, arterial blood gas, organ involvement, and pediatric risk of mortality (PRISM) score were compared between the two groups.Findings: Higher PRISM score, higher positive end-expiratory pressure (PEEP) and peak inspiratory pressure (PIP), and presence of other organ involvement were predictive factors of mortality (P < 0.05). However, age, gender, length of stay, weight, partial pressure of oxygen (PaO2), and partial pressure of carbon dioxide (PaCO2) were not different significantly between the two groups (P > 0.05).Conclusion: The PRISM score was a reliable predictor for mortality rate among the patients with ARDS in pediatric intensive care unit (PICU).

کلیدواژه‌ها [English]

  • Acute respiratory distress syndrome (ARDS)
  • Acute lung injury
  • Pediatric Intensive Care Units
  • Pediatric risk of mortality (PRISM) score

مراجع

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مجله دانشکده پزشکی اصفهان
دوره 35، شماره 418 - شماره پیاپی 418
فروردین و اردیبهشت 1396
صفحه 64-69

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سابقه مقاله

  • تاریخ دریافت: 07 آذر 1395
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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