Clinico-etiological profile and outcomes of acute respiratory failure in pediatric patients at a tertiary care center in central India: A prospective observational study
DOI:
https://doi.org/10.71152/ajms.v16i10.4761Keywords:
Acute respiratory failure; Children; Arterial blood gas; Pediatric intensive care unitAbstract
Background: Acute respiratory failure (ARF), a critical condition in children, is marked by impaired gas exchange (hypoxemia or hypercapnia). The etiology of ARF is diverse, including respiratory infections, central nervous system (CNS) disorders, cardiovascular diseases, and musculoskeletal conditions. Studying the clinical profile and outcomes of ARF in resource-limited settings like India, where there is a high burden of infections and malnutrition, is essential to improve early recognition and management.
Aims and Objectives: To study the clinico-etiological profile and outcomes of pediatric patients with ARF admitted at a tertiary care center in central India.
Materials and Methods: This prospective observational study was conducted in the pediatric intensive care unit over 12 months (November 2023–October 2024). A total of 50 children (1 month–14 years) with ARF (defined via arterial blood gas criteria, i.e., PaO2 <60 mmHg or PaCO2 >50 mmHg or both) were enrolled. Clinical presentation, laboratory findings, treatment approach, and outcomes were recorded and analyzed.
Results: For the 50 enrolled patients, the mean age was 4.19 (±3.8 years). Males predominated (60%, M: F = 1.5:1). Respiratory system involvement was the leading cause (58%), notably pneumonia (22%). Other etiologies included musculoskeletal (16%), cardiovascular (12%), and CNS (12%) causes of ARF. Tachypnea (84%), nasal flaring (80%), and chest retractions (80%) were common presenting signs. Type 1 (hypoxemic) ARF was most frequent (74%). Ventilation was required in 72%, i.e., 50% invasive positive pressure ventilation, 22% continuous positive airway pressure/non-invasive ventilation. Significant mortality was seen in patients requiring invasive ventilation (P=0.001) and those with respiratory system involvement (P=0.034).
Conclusion: ARF in children has significant mortality (44%). Respiratory infections remain the leading cause. Early identification and appropriate intervention are key to improving prognosis in resource-limited settings.
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