Objectives: To evaluate the prevalence, causes, treatment outcomes, and associated factors of PARDS in children admitted to the pediatric intensive care unit (PICU)

Design: A hospital-based cross-sectional observational study for 1 year (July 8/2023, to June 7/2024).

Setting: Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

Patients: All patients admitted to PICU

Interventions: data was collected from a structured abstract sheet

Measurements and Main Results: A total of 343 patients were admitted to the PICU during the study period, of which 57 had PARDS: a prevalence of 16.6% (95% CI: 12.8-21.0). Infants accounted for the majority (57.9%) of PARDS cases with a median (range) age of 1.65 years (8 days – 14 years). Pneumonia or lower airway infection was the most common condition (56.1%) associated with PARDS, followed by sepsis (40.4%). The mean (SD) length of PICU stay was 12.3 (10.6) days (95% CI 9.5 – 15.1), compared to 5.4 (7.4) days (95% CI 4.5 – 6.3) in those without PARDS. The mean (SD) duration of ventilator use was also higher in patients with PARDS (9.2 (8.4) days; 95% CI, 6.94-11.4) than in non-PARDS patients (3.0 (6.2) days; 95% CI, 2.27-3.7). The overall mortality rate for patients who developed PARDS was 50.9%, significantly higher than the 23.1% mortality rate observed in patients without PARDS. Patients with PARDS accounted for 30.5% of all PICU deaths. Malnutrition (aOR=52.6; 95% CI, 1.9-1491.5 and abnormal serum sodium levels (aOR=40.5; 95% CI, 1.164-1412.8) were statistically significantly associated with increased mortality among patients with PARDS in the multivariate logistic regression analysis.

Conclusion: The prevalence of PARDS in this single-center study is higher than in many previous reports. Patients with PARDS experienced longer PICU stays, higher rates of bed and ventilator occupancy, and greater mortality compared to those without PARDS. The prevalence and mortality of PARDS may be higher in resource-limited countries than in high-income countries, warranting further multicenter studies.

TBA