Acute respiratory distress syndrome in children with severe motor and intellectual disabilities
Acute respiratory distress syndrome in children with severe motor and intellectual disabilities
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DOI：
10.1016/j.braindev.2004.09.009
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发表时间：
2005-09-01
影响因子：
1.7
通讯作者：
Abe, T
中科院分区：
文献类型：
--
作者：
Yoshikawa, H;Yamazaki, S;Abe, T
我们报告13名严重残疾儿童急性呼吸窘迫综合征，谁是在儿科治疗，新泻市总医院在1995年至2002年。这些儿童的年龄从1岁到16岁不等。所有患者均不能走动。慢性误吸和胃食管反流12例。患者有快速发作的呼吸困难，氧气治疗无效。胸部X线检查显示弥漫性双侧肺浸润。诱发事件包括败血症（3例患者）、肺炎（7例患者）、胰腺炎（1例患者）和2例儿童其他感染。所有患者均需机械通气3-26天，吸氧5-64天。类固醇治疗和表面活性剂治疗分别给予8名和3名患者。只有1例患者出现漏气并发症。尽管进行了重症监护，但仍有3名儿童死亡，1名儿童接受了气管切开术，9名儿童完全康复。急性呼吸窘迫综合征是一种常见的急性呼吸衰竭的原因后，各种侮辱。其特征是急性发作的呼吸困难，氧气治疗无效，弥漫性肺浸润。患有严重运动和智力残疾的儿童有各种并发症。本研究认为慢性误吸和胃食管反流是严重运动和智力残疾儿童急性呼吸窘迫综合征的诱发因素之一。虽然急性呼吸窘迫综合征被认为是一种不罕见的情况，但其死亡率可能很低，尽管这种疾病在严重运动和智力残疾的儿童中很严重。急性呼吸窘迫综合征是严重残疾儿童常见的并发症。(c)2004 Elsevier B. V.保留所有权利。
We report 13 severely disabled children with acute respiratory distress syndrome, who were treated at the Department of Pediatrics, Niigata City General Hospital between 1995 and 2002. The children ranged in age from 1 year to 16 years. All were non-ambulant. Chronic aspiration and gastro-esophageal reflux were recognized in 12 patients. Patients had the rapid onset of dyspnea refractory to oxygen therapy. Diffuse bilateral lung infiltrates were present on chest X-ray. Predisposing events included sepsis (3 patients), pneumomia (7 patients), pancreatitis (1 patient) and two children with other infections. All required mechanical ventilation for periods of 3-26 days and received oxygen for 5-64 days. Steroid therapy and surfactant therapy were given to eight and three patients, respectively. Only one patient developed an air leak complication. Despite intensive care, three children died, one underwent tracheostomy and nine recovered completely. Acute respiratory distress syndrome is a commonly recognized cause of acute respiratory failure following a variety of insults. It is characterized by the acute onset of dyspnea refractory to oxygen therapy, and diffuse lung infiltrates. Children with severe motor and intellectual disabilities had various complications. In this study, chronic aspiration and gastro-esophageal reflux are considered to be one of predisposing factors triggering acute respiratory distress syndrome in children With severe motor and intellectual disabilities. Although acute respiratory distress syndrome was considered to be a not infrequent occurrence; its mortality rate might be low despite the severity of the disease in children with severe motor and intellectual disabilities. Acute respiratory distress syndrome can be a complication seen in severely disabled children. (c) 2004 Elsevier B.V. All rights reserved.