학술논문
Immunocompromised-Associated Pediatric Acute Respiratory Distress Syndrome: Experience From the 2016/2017 Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Prospective Cohort Study*
Document Type
Academic Journal
Author
Gertz, Shira J.; Bhalla, Anoopindar; Chima, Ranjit S.; Emeriaud, Guillaume; Fitzgerald, Julie C.; Hsing, Deyin D.; Jeyapalan, Asumthia S.; Pike, Francis; Sallee, Colin J.; Thomas, Neal J.; Yehya, Nadir; Rowan, Courtney M.; Sforza, Jesica; Poterala, Rossana; Fernandez, Analia; Avila Vera, Antonio; Orqueda, Daniel; Agueda Vidal, Nilda; Rosemary, Deheza; Turon, Gonzalo; Monjes, Cecilia; Fernando Espanol, Segundo; Siaba Serrate, Alejandro; Iolster, Thomas; Torres, Silvio; Cinquegrani, Karina; Jose Montes, Maria; Capocasa, Patricia; Ferreyra, Marcela; Castellani, Pablo; Giampieri, Martin; Pedraza, Claudia; Martin Landry, Luis; Althabe, Maria; Vanesa Fortini, Yanina; Botta, Priscila; Paziencia, Fernando; Erickson, Simon; Barr, Samantha; Shea, Sara; Butt, Warwick; Delzoppo, Carmel; Pintimalla, Alyssa; Martinez Leon, Alejandro Fabio; Guzman Rivera, Gustavo Alfredo; Jouvet, Philippe; Emeriaud, Guillaume; Dumitrascu, Mariana; Ellen French, Mary; Caro, Daniel; Castillo, I; Andres, E.; Cruces Romero, Pablo; Medina, Tania; Pavez Madrid, Paula; Cortez, Ambar; Alvear, Jimena; Acuna, Carlos; Diaz, Franco; Jose Nunez, Maria; Wegner Araya, Adriana; Godoy Mundaca, Loreto; Chen, Yang; Perez Lozano, German; Pardo Carrero, Rosalba; Lopez Alarcon, Yurika Paola; Mazzillo Vega, Liliana; Maria Izquierdo, Ledys; Piñeres Olave, Byron Enrique; Zuluaga Orrego, Cesar; Quinonez Lopez, Deyanira; Vasquez Hoyos, Pablo; Vavrina, Martin; Zurek, Jiri; Campos-Miño, Santiago; Yerovi, Rocio; Bridier, Armelle; Payen, Valerie; Milesi, Christophe; Bourgoin, Pierre; Travert, Brendan; Genuini, Mathieu; Starck, Julie; Maria, Matthieu; Guichoux, Julie; Baudin, Florent; Briassoulis, George; Ilia, Stavroula; Di Nardo, Matteo; Camporesi, Anna; Chiusolo, Fabrizio; Shime, Nobuaki; Ohshimo, Shinichiro; Kida, Yoshiko; Kyo, Michihito; Tabata, Yuichi; Fong Tang, Swee; Wern Tai, Chian; See Lum, Lucy Chai; Elghuwael, Ismail; Jimenez Rivera, Nestor Javier; Jarillo Quijada, Alberto E; Kneyber, Martin; Dijkstra, Sandra; Beca, John; Sherring, Claire; Miriam, Rea; Vargas G, Sonia I; Vasquez Miranda, Daniel; Ramirez Cortez, Grimaldo; Tantalean, Jose; Pagowska-Klimek, Izabela; Gil Escobar, Carlos; Sousa Moniz, Marta; Camilo, Cristina; Hazwani, Tarek; Aldairi, Nedaa; Al Amoudi, Ahmed; Alahmadti, Ahmad; Taylor, Ryan; Mendizabal, Mikel; Goni Orayen, Concepcion; Lopez Fernandez, Yolanda; Ramon Valle, Juan; Martinez, Lidia; Pilar Orive, Javier; Brezmes, Marta; Lopez-Herce, Jesus; Parrilla, Julio; Gaboli, Mirella; Gonzalez Gomez, Jose Manuel; Morales Martinez, Antonio; Alapont, Vicent Modesto I; Sanchez Diaz, Juan Ignacio; Llorente de la Fuente, Ana M.; Palanca Arias, Daniel; Madurga Revilla, Paula; Martinez de Azagra, Amelia; Garcia Gonzalez, Maria; Arjona Villanueva, David; Garcia Casas, Paula; Brio Sanagustin, Sonia; Pons Odena, Marti; Medina, Alberto; Onate Vergara, Eider; Rodriguez Campoy, Patricia; Reyes Dominguez, Susana; Dursun, Oguz; Atike Ongun, Ebru; Kamit Can, Fulya; Berna Anil, Ayse; Baines, Paul; Walsh, Laura; Jones, Dawn; Sadasivam, Kalaimaran; Mildner, Reinout; Plunkett, Adrian; Lillie, Jon; Tibby, Shane; Wellman, Paul; Belfield, Holly; Brierley, Joe; Dominguez, Troy E.; Abaleke, Eugenia; Feinstein, Yael; Deep, Akash; Sundararajan, Santosh; Oruganti, Siva; Silvestre, Catarina; Weitz, James; Sheward, Victoria; Macrae, Duncan; Aramburo, Angela; Fortune, Peter-Marc; Subramanian, Gayathri; Jennings, Claire; Dwarakanathan, Buvana; Inwald, David; Feather, Calandra; Agbeko, Rachel; Lawton-Woodhall, Angela; McIntyre, Karen; Sykes, Kim; Pappachan, Jon; Gale, Helen; Mellish, Christie; McCorkell, Jenni; Torero, Luis; Nofziger, Ryan; Latifi, Samir; Anthony, Heather; Sanders, Ron; Hefley, Glenda; Virk, Manpreet; Jaimon, Nancy; Maddux, Aline B.; Mourani, Peter M.; Ralston, Kimberly; Sierra, Yamila; Khemani, Robinder; Newth, Christopher; Bhalla, Anoopindar; Kwok, Jeni; Morzov, Rica; Mahapatra, Sidharth; Truemper, Edward; Kustka, Lucinda; Nett, Sholeen T.; Singleton, Marcy; Dean Jarvis, J.; Yehya, Nadir; Napolitano, Natalie; Murphy, Marie; Ronan, Laurie; Morgan, Ryan; Kubis, Sherri; Broden, Elizabeth; Willson, Douglas; Henderson, Grace; Gedeit, Rainer; Murkowski, Kathy; Woods, Katherine; Kasch, Mary; Han, Yong Y; Affolter, Jeremy T; Tieves, Kelly S; Hughes-Schalk, Amber; Chima, Ranjit S.; Krallman, Kelli; Stoneman, Erin; Benken, Laura; Yunger, Toni; Schneider, James; Sweberg, Todd; Kessel, Aaron; Carroll, Christopher L.; Santanelli, James; Ackerman, Kate G; Cullimore, Melissa; Rowan, Courtney; Bales, Melissa; Keith Dockery, W.; Jafari-Namin, Shirin; Barry, Dana; Jane’t, Keary; Alibrahim, Omar; Patankar, Nikhil; Qiao, Haiping; Gertz, Shira; Su, Felice; Haileselassie, Bereketeab; Song, Hanqiu; Bysani, Kris; Monjure, Tracey; Beltramo, Fernando; Totapally, Balagangadhar; Govantes, Beatriz; Coates, Bria; Wellisch, Lawren; Allen, Kiona; Shukla, Avani; Thomas, Neal J.; Spear, Debbie; Shein, Steven L.; Gertz, Shira; Parker, Margaret M.; Sloniewsky, Daniel; Allen, Christine; Harrell, Amy; Pinto, Neethi; Kniola, Allison; Rodgers, Chiara; Cvijanovich, Natalie; Typpo, Katri; Kelley, Connor; King, Caroline; Sapru, Anil; Ratiu, Anna; Ashtari, Neda; Sikora, Lindsay; Jeyapalan, Asumthia S.; Coronado-Munoz, Alvaro; Flori, Heidi; Dahmer, Mary K.; Jayachandran, Chaandini; Hume, Janet; Nerheim, Dan; Smith, Rebecca; Spaeder, Michael; Adu-Darko, Michelle; Smith, Lincoln; Hartmann, Silvia; Sullivan, Erin; Merritt, Courtney; Al-Subu, Awni; Blom, Andrea; Lin, John C.; Spinella, Philip; Hsing, Deyin D.; Pon, Steve; Brian Estil, Jim; Gautam, Richa; Giuliano, John S., Jr; Tala, Joana
Source
Pediatric Critical Care Medicine. Apr 01, 2024 25(4):288-300
Subject
Language
English
ISSN
1529-7535
Abstract
OBJECTIVES:: To characterize immunocompromised-associated pediatric acute respiratory distress syndrome (I-PARDS) and contrast it to PARDS. DESIGN:: This is a secondary analysis of the 2016–2017 PARDS incidence and epidemiology (PARDIE) study, a prospective observational, cross-sectional study of children with PARDS. SETTING:: Dataset of 145 PICUs across 27 countries. PATIENTS:: During 10 nonconsecutive weeks (from May 2016 to June 2017), data about immunocompromising conditions (ICCs, defined as malignancy, congenital/acquired immunodeficiency, posttransplantation, or diseases requiring immunosuppression) were collected. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Of 708 subjects, 105 (14.8%) had ICC. Before the development of I-PARDS, those with ICC were more likely to be hospitalized (70% vs. 35%, p < 0.001), have more at-risk for PARDS (p = 0.046), and spent more hours at-risk (20 [interquartile range, IQR: 8–46] vs. 11 [IQR: 4–33], [p = 0.002]). Noninvasive ventilation (NIV) use was more common in those with ICC (p < 0.001). Of those diagnosed with PARDS on NIV (n = 161), children with ICC were more likely to be subsequently intubated (n = 28/40 [70%] vs n = 53/121 [44%], p = 0.004). Severe PARDS was more common (32% vs 23%, p < 0.001) in I-PARDS. Oxygenation indices were higher at diagnosis and had less improvement over the first 3 days of PARDS (p < 0.001). Children with I-PARDS had greater nonpulmonary organ dysfunction. Adjusting for Pediatric Risk of Mortality IV and oxygenation index, children with I-PARDS had a higher severity of illness-adjusted PICU mortality (adjusted hazard ratio: 3.0 [95% CI, 1.9–4.7] p < 0.001) and were less likely to be extubated alive within 28 days (subdistribution hazard ratio: 0.47 [95% CI, 0.31–0.71] p < 0.001). CONCLUSIONS:: I-PARDS is a unique subtype of PARDS associated with hospitalization before diagnosis and increased: time at-risk for PARDS, NIV use, hypoxia, nonpulmonary organ dysfunction, and mortality. The opportunity for early detection and intervention seems to exist. Dedicated study in these patients is imperative to determine if targeted interventions will benefit these unique patients with the ultimate goal of improving outcomes.