Study design: This is a prospective, multicenter, and observational study with the aim of describing physiological characteristics, respiratory management, and outcomes of children with acute hypoxemic respiratory failure (AHRF) from different etiologies receiving invasive mechanical ventilation (IMV) compared with those affected by SARS-CoV-2. Methods and Main Results: Twenty-eight patients met the inclusion criteria: 9 patients with coronavirus disease 2019 (COVID-19) and 19 patients without COVID-19. Non-COVID-19 patients had more pre-existing comorbidities (78.9% vs. 44.4%) than COVID-19 patients. At AHRF onset, non-COVID-19 patients had worse oxygenation (PaO 2 /FiO 2 = 95 mmHg (65.5–133) vs. 150 mmHg (105–220), p = 0.04), oxygenation index = 15.9 (11–28.4) vs. 9.3 (6.7–10.6), p = 0.01), and higher PaCO 2 (48 mmHg (46.5–63) vs. 41 mmHg (40–45), p = 0.07, that remained higher at 48 h: 54 mmHg (43–58.7) vs. 41 (38.5–45.5), p = 0.03). In 12 patients (5 COVID-19 and 7 non-COVID-19), AHRF evolved to pediatric acute respiratory distress syndrome (PARDS). All non-COVID-19 patients had severe PARDS, while 3 out of 5 patients in the COVID-19 group had mild or moderate PARDS. Overall Pediatric Intensive Care Medicine (PICU) mortality was 14.3%. Conclusions: Children with AHRF due to SARS-CoV2 infection had fewer comorbidities and better oxygenation than patients with non-COVID-19 AHRF. In this study, progression to severe PARDS was rarely observed in children with COVID-19.
【저자키워드】 Coronavirus disease 2019, acute respiratory distress syndrome, mechanical ventilation, children, Acute hypoxemic respiratory failure, 【초록키워드】 COVID-19, coronavirus disease, SARS-CoV-2, Respiratory failure, Mortality, pediatric, Comorbidity, progression, outcome, SARS-CoV2 infection, Medicine, Characteristics, management, Patient, Mild, multicenter, etiology, moderate, COVID-19 patients, acute respiratory distress, Invasive mechanical ventilation, physiological, Oxygenation, AHRF, Non-COVID-19, syndrome, COVID-19 group, oxygenation index, hypoxemic, Inclusion, IMV, affected, remained, receiving, children with COVID-19, had more, non-COVID-19 patient, PaO, patients without COVID-19, 【제목키워드】 COVID-19, respiratory, experience, failure,