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J Pediatr Intensive Care 2020; 09(02): 092-098
DOI: 10.1055/s-0039-3400962
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Predicting Outcome in Mechanically Ventilated Pediatric Patients

Selman Kesici 
1   Pediatric Intensive Care Unit, İhsan Doğramacı Children's Hospital, Hacettepe University, Ankara, Turkey
,
Şenay Kenç
2   Department of Pediatric Gastroenterology, İnönü University, Malatya, Turkey
,
Ayşe Filiz Yetimakman 
3   Pediatric Intensive Care Unit, Kocaeli University, Kocaeli, Turkey
,
Benan Bayrakci
1   Pediatric Intensive Care Unit, İhsan Doğramacı Children's Hospital, Hacettepe University, Ankara, Turkey
› Author Affiliations Funding None.
Further Information

Publication History

19 August 2019

29 October 2019

Publication Date:
03 December 2019 (online)

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Abstract

To apply and determine whether standardized mortality scores are appropriate to predict the risk of mortality in mechanically ventilated pediatric patients, 150 patients were retrospectively evaluated. Pediatric risk of mortality (PRISM) III-24 and pediatric index of mortality (PIM)-2 scores were unable to discriminate survivors and nonsurvivors; the observed mortality rate was lower than expected mortality rates. Oxygenation index (OI) was calculated at 0, 12, 24, and 72 hours of ventilation. OI-12 and OI-72 were found to be higher in nonsurvivors. PRISM III-24 and PIM-2 scores failed to predict mortality risk in mechanically ventilated pediatric patients. OI can be used to predict degree of respiratory failure and mortality risk.

Keywords

pediatric - mortality scores - mechanical ventilation - oxygenation index
 

  • References

  • 1 Rapoport J, Teres D, Lemeshow S, Gehlbach S. A method for assessing the clinical performance and cost-effectiveness of intensive care units: a multicenter inception cohort study. Crit Care Med 1994; 22 (09) 1385-1391
    CrossrefPubMedGoogle Scholar
  • 2 Shortell SM, Zimmerman JE, Rousseau DM. , et al. The performance of intensive care units: does good management make a difference?. Med Care 1994; 32 (05) 508-525
    CrossrefPubMedGoogle Scholar
  • 3 Pollack MM, Cuerdon TT, Patel KM, Ruttimann UE, Getson PR, Levetown M. Impact of quality-of-care factors on pediatric intensive care unit mortality. JAMA 1994; 272 (12) 941-946
    CrossrefPubMedGoogle Scholar
  • 4 Pollack MM, Ruttimann UE, Getson PR. Pediatric risk of mortality (PRISM) score. Crit Care Med 1988; 16 (11) 1110-1116
    CrossrefPubMedGoogle Scholar
  • 5 Shann F, Pearson G, Slater A, Wilkinson K. Paediatric index of mortality (PIM): a mortality prediction model for children in intensive care. Intensive Care Med 1997; 23 (02) 201-207
    CrossrefPubMedGoogle Scholar
  • 6 Gemke RJ, van Vught J. Scoring systems in pediatric intensive care: PRISM III versus PIM. Intensive Care Med 2002; 28 (02) 204-207
    CrossrefPubMedGoogle Scholar
  • 7 Slater A, Shann F. ; ANZICS Paediatric Study Group. The suitability of the pediatric index of mortality (PIM), PIM2, the pediatric risk of mortality (PRISM), and PRISM III for monitoring the quality of pediatric intensive care in Australia and New Zealand. Pediatr Crit Care Med 2004; 5 (05) 447-454
    CrossrefPubMedGoogle Scholar
  • 8 Choi KM, Ng DK, Wong SF. , et al. Assessment of the pediatric index of mortality (PIM) and the pediatric risk of mortality (PRISM) III score for prediction of mortality in a paediatric intensive care unit in Hong Kong. Hong Kong Med J 2005; 11 (02) 97-103
    PubMedGoogle Scholar
  • 9 Thukral A, Lodha R, Irshad M, Arora NK. Performance of pediatric risk of mortality (PRISM), pediatric index of mortality (PIM), and PIM2 in a pediatric intensive care unit in a developing country. Pediatr Crit Care Med 2006; 7 (04) 356-361
    CrossrefPubMedGoogle Scholar
  • 10 Flori HR, Glidden DV, Rutherford GW, Matthay MA. Pediatric acute lung injury: prospective evaluation of risk factors associated with mortality. Am J Respir Crit Care Med 2005; 171 (09) 995-1001
    CrossrefPubMedGoogle Scholar
  • 11 Seeley E, McAuley DF, Eisner M, Miletin M, Matthay MA, Kallet RH. Predictors of mortality in acute lung injury during the era of lung protective ventilation. Thorax 2008; 63 (11) 994-998
    CrossrefPubMedGoogle Scholar
  • 12 Tamburro RF, Bugnitz MC, Stidham GL. Alveolar-arterial oxygen gradient as a predictor of outcome in patients with nonneonatal pediatric respiratory failure. J Pediatr 1991; 119 (06) 935-938
    CrossrefPubMedGoogle Scholar
  • 13 Green TP, Timmons OD, Fackler JC, Moler FW, Thompson AE, Sweeney MF. ; Pediatric Critical Care Study Group. The impact of extracorporeal membrane oxygenation on survival in pediatric patients with acute respiratory failure. Crit Care Med 1996; 24 (02) 323-329
    CrossrefPubMedGoogle Scholar
  • 14 Arnold JH, Anas NG, Luckett P. , et al. High-frequency oscillatory ventilation in pediatric respiratory failure: a multicenter experience. Crit Care Med 2000; 28 (12) 3913-3919
    CrossrefPubMedGoogle Scholar
  • 15 Kao HC, Lai TY, Hung HL. , et al. Sequential oxygenation index and organ dysfunction assessment within the first 3 days of mechanical ventilation predict the outcome of adult patients with severe acute respiratory failure. ScientificWorldJournal 2013; 2013: 413216
    PubMedGoogle Scholar
  • 16 Trachsel D, McCrindle BW, Nakagawa S, Bohn D. Oxygenation index predicts outcome in children with acute hypoxemic respiratory failure. Am J Respir Crit Care Med 2005; 172 (02) 206-211
    CrossrefPubMedGoogle Scholar
  • 17 Mann PC, Morriss Jr FH, Klein JM. Prediction of survival in infants with congenital diaphragmatic hernia based on stomach position, surgical timing, and oxygenation index. Am J Perinatol 2012; 29 (05) 383-390
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Pollack MM, Patel KM, Ruttimann UE. PRISM III: an updated pediatric risk of mortality score. Crit Care Med 1996; 24 (05) 743-752
    CrossrefPubMedGoogle Scholar
  • 19 Slater A, Shann F, Pearson G. ; Paediatric Index of Mortality (PIM) Study Group. PIM2: a revised version of the paediatric index of mortality. Intensive Care Med 2003; 29 (02) 278-285
    CrossrefPubMedGoogle Scholar
  • 20 Leteurtre S, Martinot A, Duhamel A. , et al. Development of a pediatric multiple organ dysfunction score: use of two strategies. Med Decis Making 1999; 19 (04) 399-410
    CrossrefPubMedGoogle Scholar
  • 21 Visser IH, Hazelzet JA, Albers MJ. , et al. Mortality prediction models for pediatric intensive care: comparison of overall and subgroup specific performance. Intensive Care Med 2013; 39 (05) 942-950
    CrossrefPubMedGoogle Scholar
  • 22 Hosmer DW, Taber S, Lemeshow S. The importance of assessing the fit of logistic regression models: a case study. Am J Public Health 1991; 81 (12) 1630-1635
    CrossrefPubMedGoogle Scholar
  • 23 Proulx F, Fayon M, Farrell CA, Lacroix J, Gauthier M. Epidemiology of sepsis and multiple organ dysfunction syndrome in children. Chest 1996; 109 (04) 1033-1037
    CrossrefPubMedGoogle Scholar
  • 24 Proulx F, Gauthier M, Nadeau D, Lacroix J, Farrell CA. Timing and predictors of death in pediatric patients with multiple organ system failure. Crit Care Med 1994; 22 (06) 1025-1031
    CrossrefPubMedGoogle Scholar
  • 25 Oymak Y, Bayrakci B. The suitability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality (PRISM) for pediatric intensive care in Turkey. Turkish J Pediatr Disease 2017; 1: 1-5
    PubMedGoogle Scholar
  • 26 Deerojanawong J, Prapphal N, Udomittipong K. PRISM score and factors predicting mortality of patients with respiratory failure in the pediatric intensive care unit. J Med Assoc Thai 2001; 84 (Suppl. 01) S68-S75
    PubMedGoogle Scholar
  • 27 Ranieri VM, Rubenfeld GD, Thompson BT. , et al; ARDS Definition Task Force. Acute respiratory distress syndrome: the Berlin Definition. JAMA 2012; 307 (23) 2526-2533
    PubMedGoogle Scholar