964: DISCHARGE DISPOSITION AND ONE-YEAR MORTALITY AFTER PEDIATRIC ACUTE RESPIRATORY DISTRESS SYNDROME

At the end of 2019, there was a pandemic happening in the world, called the novel Coronavirus disease-19 (COVID-19). Various spectrums of disease from COVID-19, one of which is ARDS. The incidence of COVID-19 in children is not as much as in adults. However, in children under one year of age it can get worse. The main characteristic of worsening infection is the occurrence of ARDS. Objective: To find out the best treatment for PARDS in COVID-19 patients. Method: The writing of this article uses various sources from scientific journals to government guidelines and related institutions. Search articles using the keywords “Acute Respiratory Distress Syndrome”, “ARDS”, “Pediatric Respiratory Distress Syndrome”, “PARDS”, and “PARDS on COVID-19” Result and Discussion: PARDS was defined based on PALICC in 2015. Pathophysiology of PARDS in COVID-19 patients is still unclear. However, there is a theory that explains the way SARS-Cov-2 enters cells, namely through membrane fusion, giving rise to ARDS. The difference in handling PARDS for COVID-19 patients is that the handling technique is more alert to the risk of aerosols. Conclusions: There are differences in the handling of PARDS for COVID-19 patients in the technique by reducing the risk of virus transmission by preventing leakage when using a ventilator and using a bacterial/virus filter, as well as rescuers and staff using complete PPE during the procedure.

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One-Year Outcomes in Survivors of the Acute Respiratory Distress Syndrome

New England Journal of Medicine ◽

10.1056/nejmoa022450 ◽

2003 ◽

Vol 348 (8) ◽

pp. 683-693 ◽

Cited By ~ 1282

Author(s):

Margaret S. Herridge ◽

Angela M. Cheung ◽

Catherine M. Tansey ◽

Andrea Matte-Martyn ◽

Natalia Diaz-Granados ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

One Year

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One-year experience with an acute respiratory distress syndrome standard operating procedure on intensive care unit

Journal of Critical Care ◽

10.1016/j.jcrc.2015.06.024 ◽

2015 ◽

Vol 30 (5) ◽

pp. 1114-1118 ◽

Cited By ~ 3

Author(s):

Peter Luedike ◽

Matthias Totzeck ◽

Christos Rammos ◽

Detlef Kindgen-Milles ◽

Malte Kelm ◽

...

Keyword(s):

Intensive Care Unit ◽

Acute Respiratory Distress Syndrome ◽

Intensive Care ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Operating Procedure ◽

Distress Syndrome ◽

Standard Operating Procedure ◽

Standard Operating ◽

One Year

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One-year outcomes of rosuvastatin versus placebo in sepsis-associated acute respiratory distress syndrome: prospective follow-up of SAILS randomised trial

Thorax ◽

10.1136/thoraxjnl-2015-208017 ◽

2016 ◽

Vol 71 (5) ◽

pp. 401-410 ◽

Cited By ~ 35

Author(s):

Victor D Dinglas ◽

Ramona O Hopkins ◽

Amy W Wozniak ◽

Catherine L Hough ◽

Peter E Morris ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Randomised Trial ◽

One Year

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The maladaptive vascular response in COVID-19 acute respiratory distress syndrome and recovery

10.1101/2021.05.20.21257542 ◽

2021 ◽

Author(s):

David R Price ◽

Elisa Benedetti ◽

Katherine Hoffman ◽

Luis Gomez-Escobar ◽

Sergio Alvarez-Mulett ◽

...

Keyword(s):

At Risk ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Vascular Injury ◽

Distress Syndrome ◽

Vascular Response ◽

Early Signal ◽

One Year

Vascular injury is a menacing element of acute respiratory distress syndrome (ARDS) pathogenesis. To better understand the role of vascular injury in COVID-19 ARDS, we used lung autopsy immunohistochemistry and blood proteomics from COVID-19 subjects at distinct timepoints in disease pathogenesis, including a hospitalized cohort at risk of ARDS development ("at risk", N=59), an intensive care unit cohort with ARDS ("ARDS", N=31), and a cohort recovering from ARDS ("recovery", N=12). COVID-19 ARDS lung autopsy tissue revealed an association between vascular injury and platelet-rich microthrombi. This link guided the derivation of a protein signature in the at risk cohort characterized by lower expression of vascular proteins in subjects who died, an early signal of vascular limitation termed the maladaptive vascular response. These findings were replicated in COVID-19 ARDS subjects, as well as when bacterial and influenza ARDS patients (N=29) were considered, hinting at a common final pathway of vascular injury that is more disease (ARDS) then cause (COVID-19) specific, and may be related to vascular cell death. Among recovery subjects, our vascular signature identified patients with good functional recovery one year later. This vascular injury signature could be used to identify ARDS patients most likely to benefit from vascular targeted therapies.

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Manual vs Automatic Prone Positioning and Patient Outcomes in Acute Respiratory Distress Syndrome

American Journal of Critical Care ◽

10.4037/ajcc2021674 ◽

2021 ◽

Vol 30 (2) ◽

pp. 104-112

Author(s):

Lauren Morata ◽

Mary Lou Sole ◽

Frank Guido-Sanz ◽

Carrie Ogilvie ◽

Rebecca Rich

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Comparative Approach ◽

Prone Positioning ◽

Improvement Project ◽

Discharge Disposition ◽

Time To Initiation ◽

Nonparametric Statistical

Background Prone positioning is a standard treatment for moderate to severe acute respiratory distress syndrome (ARDS), but the outcomes associated with manual versus automatic prone positioning have not been evaluated. Objective To retrospectively evaluate outcomes associated with manual versus automatic prone positioning as part of a pronation quality improvement project implemented by a multidisciplinary team. Methods A retrospective, descriptive-comparative approach was used to analyze data from 24 months of a prone positioning protocol for ARDS. The study involved 37 patients, with 16 undergoing manual and 21 undergoing automatic prone positioning. Descriptive and nonparametric statistical analyses were used to evaluate outcomes associated with manual versus automatic prone positioning. Results Outcomes were similar between the 2 groups regarding time to initiation of prone positioning, discharge disposition, and length of stay. Manually pronated patients were less likely to experience interruptions in therapy (P = .005) and complications (P = .002). Pressure injuries were the most common type of complication, with the most frequent locations in automatically pronated patients being the head (P = .045), thorax (P = .003), and lower extremities (P = .047). Manual prone positioning resulted in a cost avoidance of $78 617 per patient. Conclusion Manual prone positioning has outcomes similar to those of automatic prone positioning with less risk of interruptions in therapy, fewer complications, and lower expense. Further research is needed to determine whether manual prone positioning is superior to automatic prone positioning in patients with ARDS.

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