RT Journal Article
T1 Acute Hypoxemic Respiratory Failure in Children at the Start of COVID-19 Outbreak: A Nationwide Experience.
A1 Lopez-Fernandez, Yolanda M
A1 Martinez-de-Azagra, Amelia
A1 Gonzalez-Gomez, Jose M
A1 Perez-Caballero Macarron, Cesar
A1 Garcia-Gonzalez, Maria
A1 Parrilla-Parrilla, Julio
A1 Miñambres-Rodriguez, Maria
A1 Madurga-Revilla, Paula
A1 Gomez-Zamora, Ana
A1 Rodriguez-Campoy, Patricia
A1 Mayordomo-Colunga, Juan
A1 Butragueño-Laiseca, Laura
A1 Nuñez-Borrero, Rocio
A1 Gonzalez-Martin, Jesus M
A1 Slutsky, Arthur S
A1 Villar, Jesus
K1 Acute hypoxemic respiratory failure
K1 Acute respiratory distress syndrome
K1 Children
K1 Coronavirus disease 2019
K1 Mechanical ventilation
AB This is a prospective, multicenter, and observational study with the aim of describing physiological characteristics, respiratory management, and outcomes of children with acute hypoxemic respiratory failure (AHRF) from different etiologies receiving invasive mechanical ventilation (IMV) compared with those affected by SARS-CoV-2. Twenty-eight patients met the inclusion criteria: 9 patients with coronavirus disease 2019 (COVID-19) and 19 patients without COVID-19. Non-COVID-19 patients had more pre-existing comorbidities (78.9% vs. 44.4%) than COVID-19 patients. At AHRF onset, non-COVID-19 patients had worse oxygenation (PaO2/FiO2 = 95 mmHg (65.5-133) vs. 150 mmHg (105-220), p = 0.04), oxygenation index = 15.9 (11-28.4) vs. 9.3 (6.7-10.6), p = 0.01), and higher PaCO2 (48 mmHg (46.5-63) vs. 41 mmHg (40-45), p = 0.07, that remained higher at 48 h: 54 mmHg (43-58.7) vs. 41 (38.5-45.5), p = 0.03). In 12 patients (5 COVID-19 and 7 non-COVID-19), AHRF evolved to pediatric acute respiratory distress syndrome (PARDS). All non-COVID-19 patients had severe PARDS, while 3 out of 5 patients in the COVID-19 group had mild or moderate PARDS. Overall Pediatric Intensive Care Medicine (PICU) mortality was 14.3%. Children with AHRF due to SARS-CoV2 infection had fewer comorbidities and better oxygenation than patients with non-COVID-19 AHRF. In this study, progression to severe PARDS was rarely observed in children with COVID-19.
PB MDPI
SN 2077-0383
YR 2021
FD 2021-09-22
LK http://hdl.handle.net/10668/18595
UL http://hdl.handle.net/10668/18595
LA en
NO López-Fernández YM, Martínez-de-Azagra A, González-Gómez JM, Pérez-Caballero Macarrón C, García-González M, Parrilla-Parrilla J, et al. Acute Hypoxemic Respiratory Failure in Children at the Start of COVID-19 Outbreak: A Nationwide Experience. J Clin Med. 2021 Sep 22;10(19):4301
NO This research received no external funding. YMLF is funded by an academic grant from the Instituto de Salud Carlos III, Madrid, Spain (PI19/00141). JV is funded by academic grants from the Instituto de Salud Carlos III, Madrid, Spain (CB06/06/1088, PI16/00049, PI19/00141), the European Regional Development Funds (FEDER). AAS is funded by academic grants from the Canadian Institutes of Health Research (CIHR) (Grant numbers: 137772, FDN143285, and OV3-170344). All authors are independent of the funding bodies.
DS RISalud
RD Apr 6, 2025