Post-discharge Outcomes of Pediatric Acute Respiratory Distress Syndrome (PARDS)

St. Justine's Hospital

Status: Enrolling

Conditions: Pediatric Acute Respiratory Distress Syndrome

Treatments: Other: Prospective follow-up

Study type: Observational

Funder types: Other

Identifiers

NCT03585582

MRC-155352

Details and patient eligibility

About

In this study, the investigators aim to better characterize the outcomes of pediatric acute respiratory distress syndrome (PARDS) survivors, to examine whether subgroups of children with PARDS can be identified, and to determine whether an earlier diagnosis of PARDS using a computerized decision support system will improve the care of these children.

Full description

Pediatric acute respiratory distress syndrome (PARDS), a heterogeneous clinical syndrome characterized by acute lung injury and hypoxemia, affects up to 10% of pediatric intensive care unit (ICU) patients and has a mortality rate of 18-27%. Because children who survived PARDS are still developing, long-term morbidities are highly relevant, although data on the outcomes of PARDS survivors is lacking. Previous studies were limited by their sample size, were outdated in PARDS management strategies, and used the adult ARDS diagnostic criteria. Some studies focused on pulmonary function but not on other patient-oriented outcomes such as respiratory symptoms, mental health issues, quality of life, and health care resource use, all of which have been identified as prevalent issues in adult ARDS survivors. Recently, adult studies have identified 2 distinct ARDS subphenotypes with differential responses to treatment using clinical and limited biological data, providing insight on the pathophysiology of ARDS. Whether these phenotypes are present in PARDS is unknown. Furthermore, integrating newer technologies such as transcriptomics in the identification of subphenotypes may improve our understanding of disease mechanisms. Finally, delays in ARDS diagnosis are common and compliance with current ARDS ventilation management guidelines is poor, ranging from 20-39% even in patients selected for clinical trials. Thus, novel methods such as decision support systems may play a role in the diagnosis and management of PARDS patients, although this remains to be evaluated.

Enrollment: 77 estimated patients

Sex: All

Ages: Under 18 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria:

• clinical diagnosis of PARDS, as defined by PALICC
• aged less than 18 years
• admitted to the intensive care unit

Exclusion Criteria

• none

Trial design

77 participants in 1 patient group

PARDS survivors

Description:

1. Children \<18 years 2. diagnosed with PARDS, as defined by PALICC 3. admitted to the ICU at the CHUSJ, a pediatric tertiary care center

Treatment:

Other: Prospective follow-up