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Published in: Annals of Intensive Care 1/2022

Open Access 01-12-2022 | Pulmonary-Function Tests | Research

Whole pulmonary assessment 1 year after paediatric acute respiratory distress syndrome: prospective multicentre study

Authors: Véronique Nève, Ahmed Sadik, Laurent Petyt, Stéphane Dauger, Ahmed Kheniche, André Denjean, Pierre-Louis Léger, François Chalard, Michèle Boulé, Etienne Javouhey, Philippe Reix, Isabelle Canterino, Valérie Deken, Régis Matran, Stéphane Leteurtre, Francis Leclerc

Published in: Annals of Intensive Care | Issue 1/2022

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Abstract

Background

Long-term pulmonary sequelae, including 1-year thoracic computed tomography (CT) sequelae of paediatric acute respiratory distress syndrome (ARDS) remain unknown. The purpose of the study was to determine pulmonary abnormalities in child survivors of pulmonary (p-ARDS) and extra-pulmonary ARDS (ep-ARDS) 1 year after paediatric intensive care unit discharge (PICUD).

Methods

Prospective multicentre study in four paediatric academic centres between 2005 and 2014. Patients with ARDS were assessed 1 year after PICUD with respiratory symptom questionnaire, thoracic CT and pulmonary function tests (PFT).

Results

39 patients (31 p-ARDS) aged 1.1–16.2 years were assessed. Respiratory symptoms at rest or exercise and/or respiratory maintenance treatment were reported in 23 (74%) of children with p-ARDS but in 1 (13%) of those with ep-ARDS. Thoracic CT abnormalities were observed in 18 (60%) of children with p-ARDS and 4 (50%) of those with ep-ARDS. Diffuse and more important CT abnormalities, such as ground glass opacities or mosaic perfusion patterns, were observed in 5 (13%) of children, all with p-ARDS. PFT abnormalities were observed in 30 (86%) of patients: lung hyperinflation and/or obstructive pattern in 12 (34%) children, restrictive abnormalities in 6 (50%), mild decrease in diffusing capacity in 2 (38%) and 6-min walking distance decrease in 11 (73%). Important PFT abnormalities were observed in 7 (20%) children, all with p-ARDS. Increasing driving pressure (max plateau pressure—max positive end-expiratory pressure) was correlated with increasing CT-scan abnormalities and increasing functional residual capacity (more hyperinflation) (p < 0.005).

Conclusions

Children surviving ARDS requiring mechanical ventilation present frequent respiratory symptoms, significant CT-scan and PFT abnormalities 1 year after PICUD. This highlights the need for a systematic pulmonary assessment of these children.
Trial registration The study was registered on Clinical Trials.gov PRS (ID NCT01435889)
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Literature
1.
go back to reference Quasney MW, López-Fernández YM, Santschi M, Watson RS, Pediatric Acute Lung Injury Consensus Conference Group. The outcomes of children with pediatric acute respiratory distress syndrome: proceedings from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015;16(51):S118-131.CrossRef Quasney MW, López-Fernández YM, Santschi M, Watson RS, Pediatric Acute Lung Injury Consensus Conference Group. The outcomes of children with pediatric acute respiratory distress syndrome: proceedings from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015;16(51):S118-131.CrossRef
2.
go back to reference Boucher V, Mathy C, Lacroix J, Émériaud G, Jouvet P, Tse SM. Post-discharge respiratory outcomes of children with acute respiratory distress syndrome. Pediatr Pulmonol. 2020;55(2):468–73.CrossRef Boucher V, Mathy C, Lacroix J, Émériaud G, Jouvet P, Tse SM. Post-discharge respiratory outcomes of children with acute respiratory distress syndrome. Pediatr Pulmonol. 2020;55(2):468–73.CrossRef
4.
go back to reference Kim SJ, Oh BJ, Lee JS, Lim CM, Shim TS, Lee SD, et al. Recovery from lung injury in survivors of acute respiratory distress syndrome: difference between pulmonary and extrapulmonary subtypes. Intensive Care Med. 2004;30(10):1960–3.CrossRef Kim SJ, Oh BJ, Lee JS, Lim CM, Shim TS, Lee SD, et al. Recovery from lung injury in survivors of acute respiratory distress syndrome: difference between pulmonary and extrapulmonary subtypes. Intensive Care Med. 2004;30(10):1960–3.CrossRef
5.
go back to reference Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, The American-European Consensus Conference on ARDS, et al. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149(3 Pt 1):818–24.CrossRef Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, The American-European Consensus Conference on ARDS, et al. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149(3 Pt 1):818–24.CrossRef
6.
go back to reference Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015;16(5):428–39.CrossRef Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015;16(5):428–39.CrossRef
7.
go back to reference Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, et al. Multi-ethnic reference values for spirometry for the 3–95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40(6):1324–43.CrossRef Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, et al. Multi-ethnic reference values for spirometry for the 3–95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40(6):1324–43.CrossRef
8.
go back to reference Stanojevic S, Graham BL, Cooper BG, Thompson BR, Carter KW, Francis RW, et al. Official ERS technical standards: global Lung Function Initiative reference values for the carbon monoxide transfer factor for Caucasians. Eur Respir J. 2017;50(3). Stanojevic S, Graham BL, Cooper BG, Thompson BR, Carter KW, Francis RW, et al. Official ERS technical standards: global Lung Function Initiative reference values for the carbon monoxide transfer factor for Caucasians. Eur Respir J. 2017;50(3).
10.
go back to reference Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Eur Respir J Suppl. 1993;16:5–40.CrossRef Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Eur Respir J Suppl. 1993;16:5–40.CrossRef
11.
go back to reference Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948–68.CrossRef Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948–68.CrossRef
12.
go back to reference Rimensberger PC, Cheifetz IM, Group for the PALICC. Ventilatory support in children with pediatric acute respiratory distress syndrome: proceedings from the pediatric acute lung injury consensus conference. Pediatr Crit Care Med. 2015;16(5_suppl):S51.CrossRef Rimensberger PC, Cheifetz IM, Group for the PALICC. Ventilatory support in children with pediatric acute respiratory distress syndrome: proceedings from the pediatric acute lung injury consensus conference. Pediatr Crit Care Med. 2015;16(5_suppl):S51.CrossRef
13.
go back to reference Wilcox ME, Patsios D, Murphy G, Kudlow P, Paul N, Tansey CM, et al. Radiologic outcomes at 5 years after severe ARDS. Chest. 2013;143(4):920–6.CrossRef Wilcox ME, Patsios D, Murphy G, Kudlow P, Paul N, Tansey CM, et al. Radiologic outcomes at 5 years after severe ARDS. Chest. 2013;143(4):920–6.CrossRef
14.
go back to reference Howling SJ, Evans TW, Hansell DM. The significance of bronchial dilatation on CT in patients with adult respiratory distress syndrome. Clin Radiol. 1998;53(2):105–9.CrossRef Howling SJ, Evans TW, Hansell DM. The significance of bronchial dilatation on CT in patients with adult respiratory distress syndrome. Clin Radiol. 1998;53(2):105–9.CrossRef
15.
go back to reference Masclans JR, Roca O, Muñoz X, Pallisa E, Torres F, Rello J, et al. Quality of life, pulmonary function, and tomographic scan abnormalities after ARDS. Chest. 2011;139(6):1340–6.CrossRef Masclans JR, Roca O, Muñoz X, Pallisa E, Torres F, Rello J, et al. Quality of life, pulmonary function, and tomographic scan abnormalities after ARDS. Chest. 2011;139(6):1340–6.CrossRef
16.
go back to reference Desai SR, Wells AU, Rubens MB, Evans TW, Hansell DM. Acute respiratory distress syndrome: CT abnormalities at long-term follow-up. Radiology. 1999;210(1):29–35.CrossRef Desai SR, Wells AU, Rubens MB, Evans TW, Hansell DM. Acute respiratory distress syndrome: CT abnormalities at long-term follow-up. Radiology. 1999;210(1):29–35.CrossRef
17.
go back to reference Nöbauer-Huhmann IM, Eibenberger K, Schaefer-Prokop C, Steltzer H, Schlick W, Strasser K, et al. Changes in lung parenchyma after acute respiratory distress syndrome (ARDS): assessment with high-resolution computed tomography. Eur Radiol. 2001;11(12):2436–43.CrossRef Nöbauer-Huhmann IM, Eibenberger K, Schaefer-Prokop C, Steltzer H, Schlick W, Strasser K, et al. Changes in lung parenchyma after acute respiratory distress syndrome (ARDS): assessment with high-resolution computed tomography. Eur Radiol. 2001;11(12):2436–43.CrossRef
18.
go back to reference Newth CJL, Sward KA, Khemani RG, Page K, Meert KL, Carcillo JA, et al. Variability in usual care mechanical ventilation for pediatric Acute Respiratory Distress Syndrome: time for a decision support protocol? Pediatr Crit Care Med. 2017;18(11):e521–9.CrossRef Newth CJL, Sward KA, Khemani RG, Page K, Meert KL, Carcillo JA, et al. Variability in usual care mechanical ventilation for pediatric Acute Respiratory Distress Syndrome: time for a decision support protocol? Pediatr Crit Care Med. 2017;18(11):e521–9.CrossRef
19.
go back to reference Chakdour S, Vaidya PC, Angurana SK, Muralidharan J, Singh M, Singhi SC. Pulmonary functions in children ventilated for acute hypoxemic respiratory failure. Pediatr Crit Care Med. 2018;19(9): e464.CrossRef Chakdour S, Vaidya PC, Angurana SK, Muralidharan J, Singh M, Singhi SC. Pulmonary functions in children ventilated for acute hypoxemic respiratory failure. Pediatr Crit Care Med. 2018;19(9): e464.CrossRef
20.
go back to reference Desai SR. Acute respiratory distress syndrome: imaging of the injured lung. Clin Radiol. 2002;57(1):8–17.CrossRef Desai SR. Acute respiratory distress syndrome: imaging of the injured lung. Clin Radiol. 2002;57(1):8–17.CrossRef
21.
go back to reference Herridge MS, Tansey CM, Matté A, Tomlinson G, Diaz-Granados N, Cooper A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293–304.CrossRef Herridge MS, Tansey CM, Matté A, Tomlinson G, Diaz-Granados N, Cooper A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293–304.CrossRef
22.
go back to reference Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348(8):683–93.CrossRef Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348(8):683–93.CrossRef
23.
go back to reference Ward SL, Turpin A, Spicer AC, Treadwell MJ, Church GD, Flori HR. Long term pulmonary function and quality of life in children after acute respiratory distress syndrome: a feasibility investigation. Pediatr Crit Care Med. 2017;18(1):e48-55.CrossRef Ward SL, Turpin A, Spicer AC, Treadwell MJ, Church GD, Flori HR. Long term pulmonary function and quality of life in children after acute respiratory distress syndrome: a feasibility investigation. Pediatr Crit Care Med. 2017;18(1):e48-55.CrossRef
24.
go back to reference Ben-Abraham R, Weinbroum AA, Roizin H, Efrati O, Augarten A, Harel R, et al. Long-term assessment of pulmonary function tests in pediatric survivors of acute respiratory distress syndrome. Med Sci Monit. 2002;8(3):CR153-157.PubMed Ben-Abraham R, Weinbroum AA, Roizin H, Efrati O, Augarten A, Harel R, et al. Long-term assessment of pulmonary function tests in pediatric survivors of acute respiratory distress syndrome. Med Sci Monit. 2002;8(3):CR153-157.PubMed
Metadata
Title
Whole pulmonary assessment 1 year after paediatric acute respiratory distress syndrome: prospective multicentre study
Authors
Véronique Nève
Ahmed Sadik
Laurent Petyt
Stéphane Dauger
Ahmed Kheniche
André Denjean
Pierre-Louis Léger
François Chalard
Michèle Boulé
Etienne Javouhey
Philippe Reix
Isabelle Canterino
Valérie Deken
Régis Matran
Stéphane Leteurtre
Francis Leclerc
Publication date
01-12-2022
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2022
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-022-01050-4

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