• Yan Li, Quan Wang, Hui Chen, Heng-Miao Gao, Tong Zhou, and Su-Yun Qian.
• Department of PICU, Beijing Children's Hospital of Capital Medical University, No. 56 Nan Li Shi Road, Beijing, 100045, China.
• World J Pediatr. 2012 Feb 1;8(1):43-6.

BackgroundAcute lung injury (ALI)/acute respiratory distress syndrome (ARDS) represents a devastating complication observed in critical care medicine. The purpose of this study is to investigate the epidemiological aspects of ALI/ARDS in pediatric intensive care unit (PICU) and risk factors of mortality.MethodsPatients with ALI/ARDS in PICU of Beijing Children's Hospital, a tertiary medical center from November 1, 2005 to October 31, 2006 were included in this prospective study. We identified the risk factors for underlying diseases and mortality during a 3-month followup using multivariate logistic regression analysis.ResultsIn 562 critically ill patients admitted to PICU of Beijing Children's Hospital, there were 15 ALI-non ARDS patients and 29 ARDS patients, resulting in an incidence of 7.8% (44/562). The mortality rate of ARDS was 24.1% (7/29) and that of ALI/ARDS was 18.2% (8/44). At a 3-month follow-up, 12 patients died after being discharged from PICU and the total mortality rate was 45.5% (20/44). ALI/ARDS patients with pulmonary disease had better outcomes than those with extra-pulmonary involvements (P<0.05). Discharge against medical advice, low PaO(2)/FiO(2) during hospital stay and high PaCO2 on PICU admission were risk factors of mortality.ConclusionsARDS has a high mortality rate in PICU, especially in those with extra-pulmonary diseases. In addition to aggressive medical management of comorbidity, lung protection and avoidance of discharge against medical advice will decrease the mortality.

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