Combination of early PaO2/FIO2 Ratio and Interferon Y-Induced Protein 10 (IP-10) Level May Predict Clinical Outcome in Pediatric Acute Respiratory Distress Syndrome
CCCF ePoster library. Shimizu K. Nov 7, 2018; 233416; 43
Dr. Kaoru Shimizu
Dr. Kaoru Shimizu
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Abstract
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Introduction: Acute respiratory distress syndrome (ARDS) has high mortality even in the pediatric population. PaO2/FIO2 (P/F) ratio and oxygenation index (OI) can stratify the disease severity. We do not know whether adding biomarker information in the early clinical course to these mechanical ventilation parameters can further precisely predict the outcome.

Objectives: We examine the hypothesis that adding interferon-γ induced protein 10 (IP-10) level at the time of diagnosis of ARDS to P/F ratio at 12 hours of mechanical ventilation can predict the outcome in pediatric ARDS patients.

Methods: A prospective observational study is carried out at a tertiary Pediatric Intensive Care Unit in Vietnam. Children between 1 month to 15 years in age who fulfill the criteria of ARDS are enrolled. P/F ratio was recorded at 12 hours of mechanical ventilation and blood sample was taken within 24 hours of mechanical ventilation and was analyzed for biomarkers.

Results: 34 patients were enrolled in the study. Age varied from 1 month to 9 years old with median of 7 months. 14 patients died (41% mortality). P/F ratio (135±91 vs. 73±30, p<0.01) at 12 hours of mechanical ventilation were significantly different between survivors and non-survivors. IP-10 level was higher in non-survivors than survivors (4040±2850 vs. 790±1995 pg/ml, p<0.001). The four groups are created based on P/F ratio and IP-10 levels and the mortality in these combinations is shown in the table.

Conclusion: The combination of early P/F ratio and IP-10 level may predict the outcome in pediatric ARDS.


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