Clinical Profile and Outcome of Acute Respiratory Failure in Children: A Prospective Study in a Tertiary Care Hospital, Nellore, Andhra Pradesh

Abstract

Background: It was to study the clinical history of acute respiratory failure in children aged between 1 month and 16 years, and to determine the outcome of respiratory failure with respect to the underlying etiology and possible causes.Methods: A prospective, hospital-analysis was conducted on 128 children aged between one month and 16 years. The study time was 24 months. In each patient with respiratory arrest or respiratory failure with SpO2 < 90 per cent, an acute respiratory failure was recorded. In all cases with signs of respiratory distress/altered breathing rhythm, the arterial blood gas (ABG) was administered, and if the cases study involved PaCO₂ > 60 mm and/or Hg PaO₂ < 50 mm Hg. Results: In the 1 month to 1 year age range a median of 78 (60.93 percent) patients were observed, and the majority were males. Pulmonary disorders accounted for most of the 77 (60.15%) cases led by the 31 (24.21%) nervous system, sepsis 11 (10.16%), and coronary system disorders 7 (5.47%). Based on an ABG study, respiratory failure was divided into three groups, of which 95 (75.00 percent) were the most frequent hypoxic respiratory failure (type 1). The most frequent source of respiratory failure and mortality was bronchopneumonia 52 (40.62 percent). Around one-third of 39 patients (30.47%) needed ventilation support; total mortality rates were 9.37%. In the highest number of undernourished children, there was grade four malnourishment and rates of mortality increased with malnourishment.Conclusion: Hypoxic type was the most common type of respiratory failure, and bronchial pneumonia was the most common cause of mortality.

Keywords: Respiratory failure; bronchial pneumonia; Ventilator support