INCIDENCE OF ACUTE RESPIRATORY-DISTRESS SYNDROME - A COMPARISON OF 2 DEFINITIONS

Objectives-To determine the incidence and outcome of acute respiratory distress syndrome (ARDS) in children by comparing two commonly used d efinitions: the lung injury score and the American-European Consensus Conference definition. The causes and risk for developing ARDS were al so studied. Methods-Part prospective and retrospective analysis of 810 0 consecutive hospital admissions from 1 June 1995 to 1 April 1997. Re sults-Twenty one patients fulfilled the criteria for ARDS. Both defini tions identified the same group of patients. The incidence was 2.8/100 0 hospital admissions or 4.2% of paediatric intensive care unit admiss ions. The main causes were sepsis and pneumonia. Mortality was 13 of 2 1. Factors predicting death were a high admission paediatric risk of m ortality (PRISM) score (30.38 v 18.75) and the presence of multiple or gan dysfunction syndrome (92% v 25%). Conclusion-Both definitions iden tified similar groups of patients. The incidence in this population wa s higher than that reported elsewhere, but mortality and cause were si milar to those in developed countries. Poor outcome was associated wit h sepsis, a high admission PRISM scare, and simultaneous occurrence of other organ dysfunction.