Studies On Clinical Characteristics And Lung Function Tests Of Acute Lung Injury/Acute Respiratory Distress Syndrome In Infants

Objective To observe the clinical characteristics of ALI/ARDS and assessment of lung function tests in survivors of ALI/ARDS in infants at acute and recovery phase, in order to know risk factors affect ALI/ARDS infants' prognosis, and lung sequelae.Method Fourteen patients with ALI/ARDS were studied,22 patients with severe pneumonia and 28 infants without lung disease served as two control groups. At the same time, recording the patients' clinical information, ventilator parameters, blood gas analysis and laboratory indices. At acute phase, ventilator parameters representing lung function were recorded, including fraction of inspired oxygen (FiO2), positive end-expiratory pressure(PEEP), PC(pressure control) above PEEP, peak inspiratory pressure(PIP), tidal volume(VTe), and so on. Lung function tests were measured with Master Screen Paed made by the German JEAGER company at resume phase. The following indices were record:respiratory rate(RR), tidal volume per kilogram(TV/kg), peak expiratory flow (PTEF), the ratio of time taken to reach peak expiratory flow to total expiratory time (tPTEF/tE), the ratio of volume taken to reach peak expiratory volume to total expiratory volume (vPEF/vE), inspiratory time (Ti), expiratory time (Te), the ratio Ti to Te (Ti/Te), time to peak expiratory flow (TPTEF), the ratio of Tidal exspiratory flow when 50% of TV is exspired to tidal inspiratory flow when 50% of TV is inspiratory (TEF50/TIF50), functional residual capacity (FRC), resistence effect (REFF).Results Only two out of 14 ALI/ARDS infants were died. (1) At acute phase, ALI/ARDS infants had lower arterial oxygen tension(PaO2) than resume phase(p<0.05), the other parameters had no significantly difference(p<0.05), but remain had obstructive compared with normal infants, vPEF/vE, tPTEF/tE and TEF50/TIF50 had significant difference(p<0.01). The other parameters include TV/Kg, PTEF. Ti, Te, Ti/Te. TPTEF, FRC, REFF had no significant difference (p>0.05). (2) In this study, most infants with ALI/ARDS had bacteria infected. The risk factors include leukocyte, active partial thromboplastin time and danger grade, in all of them, OR>l.Most infants were caesarean birth, had asphyxia, inhalation history.Conclusions Infants had caesarean birth, asphyxia, inhalation history may be susceptible populations develop ALI/ARDS. Any organism can cause ALI/ARDS. Susceptible populations develop the syndrome more often and have worse outcomes. Aggressive diagnosis and intensive treatment are essential to good outcomes in ALI/ARDS caused by infection. Leukocyte, active partial thromboplastin time and danger grade were risk factors of ALI/ARDS. Residual obstructive defect remain common after ALI/ARDS. Rehabilitation is useful to speed mobility and muscle strength.