Whole pulmonary assessment 1 year after paediatric acute respiratory distress syndrome: prospective multicentre study.
Whole pulmonary assessment 1 year after paediatric acute respiratory distress syndrome: prospective multicentre study.
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DOI：
10.1186/s13613-022-01050-4
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发表时间：
2022-08-20
影响因子：
8.1
通讯作者：
中科院分区：
文献类型：
--
作者：
儿童急性呼吸窘迫综合征(ARDS)的长期肺部后遗症，包括1年的胸部计算机断层扫描(CT)后遗症仍不清楚。本研究旨在探讨儿科重症监护病房(PICUD)出院1年后肺内(p-ARDS)和肺外ARDS(EP-ARDS)存活儿的肺部异常改变。2005至2014年间在四个儿科学术中心进行的前瞻性多中心研究。对PICUD后1年的ARDS患者进行呼吸症状问卷调查、胸部CT检查和肺功能检查。对39例(31例P-ARDS)患者进行了评估，年龄1.1~16.2岁。23例(74%)p-ARDS患儿在休息或运动和/或呼吸维持治疗时出现呼吸道症状，而在EP-ARDS患儿中有1例(13%)出现呼吸道症状。P-ARDS组18例(60%)，EP-ARDS组4例(50%)。在5例(13%)患有p-ARDS的儿童中，观察到弥漫性和更重要的CT异常，如磨玻璃样阴影或马赛克灌注型。PFT异常30例(86%)，其中肺过度充盈和/或阻塞型12例(34%)，限制性异常6例(50%)，弥散能力轻度下降2例(38%)，6分钟步行距离减少11例(73%)。7例(20%)儿童出现重要的PFT异常，均为p-ARDS。增加驾驶压力(最大平台压-最大呼气末正压)与增加CT扫描异常和增加功能残气量(更多的过度充气)相关(p <； 0.005)。存活的ARDS患儿在PICUD后1年出现频繁的呼吸道症状、显著的CT扫描和PFT异常。这凸显了对这些儿童进行系统的肺部评估的必要性。试验注册该研究已在临床试验网站上注册(ID：NCT01435889)。该研究的在线版本包含补充材料，网址为10.1186/s13613-022-01050-4。
Long-term pulmonary sequelae, including 1-year thoracic computed tomography (CT) sequelae of paediatric acute respiratory distress syndrome (ARDS) remain unknown. The purpose of the study was to determine pulmonary abnormalities in child survivors of pulmonary (p-ARDS) and extra-pulmonary ARDS (ep-ARDS) 1 year after paediatric intensive care unit discharge (PICUD). Prospective multicentre study in four paediatric academic centres between 2005 and 2014. Patients with ARDS were assessed 1 year after PICUD with respiratory symptom questionnaire, thoracic CT and pulmonary function tests (PFT). 39 patients (31 p-ARDS) aged 1.1–16.2 years were assessed. Respiratory symptoms at rest or exercise and/or respiratory maintenance treatment were reported in 23 (74%) of children with p-ARDS but in 1 (13%) of those with ep-ARDS. Thoracic CT abnormalities were observed in 18 (60%) of children with p-ARDS and 4 (50%) of those with ep-ARDS. Diffuse and more important CT abnormalities, such as ground glass opacities or mosaic perfusion patterns, were observed in 5 (13%) of children, all with p-ARDS. PFT abnormalities were observed in 30 (86%) of patients: lung hyperinflation and/or obstructive pattern in 12 (34%) children, restrictive abnormalities in 6 (50%), mild decrease in diffusing capacity in 2 (38%) and 6-min walking distance decrease in 11 (73%). Important PFT abnormalities were observed in 7 (20%) children, all with p-ARDS. Increasing driving pressure (max plateau pressure—max positive end-expiratory pressure) was correlated with increasing CT-scan abnormalities and increasing functional residual capacity (more hyperinflation) (p < 0.005). Children surviving ARDS requiring mechanical ventilation present frequent respiratory symptoms, significant CT-scan and PFT abnormalities 1 year after PICUD. This highlights the need for a systematic pulmonary assessment of these children. Trial registration The study was registered on Clinical Trials.gov PRS (ID NCT01435889) The online version contains supplementary material available at 10.1186/s13613-022-01050-4.
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DOI：
10.1183/09031936.00080312
发表时间：
2012-12
期刊：
The European respiratory journal
影响因子：
--
作者：
Quanjer PH;Stanojevic S;Cole TJ;Baur X;Hall GL;Culver BH;Enright PL;Hankinson JL;Ip MS;Zheng J;Stocks J;ERS Global Lung Function Initiative
通讯作者：
ERS Global Lung Function Initiative
影响因子：
4.1
作者：
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通讯作者：
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影响因子：
38.9
作者：
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通讯作者：
Koh, Y
影响因子：
3.1
作者：
Boucher, Valerie;Mathy, Clemence;Tse, Sze Man
通讯作者：
Tse, Sze Man
影响因子：
19.7
作者：
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通讯作者：
Hansell, DM