Clinical Profile and Outcome of Acute Respiratory Failure in Children: A Prospective Study in a Tertiary Care Hospital

Abstract

Background: It was to study the clinical pattern of acute respiratory failure in children from 1 month to 15 years of age and to determine the outcome of respiratory failure in relation to underlying etiology and associated factors.

Methods: A hospital-based prospective study was conducted on 115 children in the age group from 1 month to 15 years. The duration of the study was 18 months. Acute respiratory failure was identified in any patient presenting with respiratory arrest or respiratory distress with SpO₂< 90%. The arterial blood gas (ABG) was done in all the patients showing signs of respiratory distress/altered respiratory pattern, and were included in the study if PaO₂< 50 mm Hg  and/or PaCO₂> 60 mm Hg.

Results: Maximum patients (56.52%) were observed in the age group of 1 month to 1 year and majority was males. Pulmonary diseases accounted for majority (62.60%) of cases, followed by nervous system (23.50%), sepsis (9.56%) and cardiovascular system diseases (4.34%). The respiratory failure was classified into three types based on ABG analysis, of which hypoxic respiratory failure (type 1) was the commonest (74.78%). The commonest cause of respiratory failure and mortality was bronchopneumonia (42.60%). About one-third of the patients (33.91%) required ventilation support. Overall mortality rate was 14.14%. Among the malnourished children maximum number had grade IV malnutrition, and the mortality rate increased with the grade of malnutrition.

Conclusion: The commonest type of respiratory failure was hypoxic type, and bronchopneumonia was the commonest cause of mortality.




Int J Clin Pediatr. 2014;3(2):46-50
doi: http://dx.doi.org/10.14740/ijcp145w