Trachsel et al identifed factors associated with the outcome for a child with acute hypoxemic respiratory failure. These can help to identify a child who may require more aggressive management. The authors are from the Hospital for Sick Children and University of Toronto.
Patient selection: pediatric patient with acute hypoxemic respiratory failure, age <= 18 years
Predictors of mortality:
(1) peak oxygenation index at any time point
(2) PRISM score within the first 12 hours of mechanical ventilation, from 0 to 76
percent mortality without extubation from Figure 4 =
= (-0.00065497 * ((OI)^3)) + (0.053102 * ((OI)^2)) + (0.47347 * (OI)) + 10.72
Predictors of longer to time extubation (duration of mechanical ventilation):
(1) peak oxygenation index
(2) younger age (mean age in population 4.9 years)
(3) need for renal replacement therapy (i.e., renal organ failure)
The chance of survival was high with early extubation.
Mortality rate for acute hypoxemic respiratory failure and underlying condition:
(1) due to pneumonia: 30%
(2) due to sepsis: 37%
(3) due to trauma: 36%
(4) in bone marrow transplant: 63%
(5) in immunosuppressed patient: 41%
(6) in bronchopulmonary dysplasia: 33%
