Outcome of Paediatric ARDS

Despite increasing indications that there are significant long-term consequences in adult survivors of ARDS, the long-term consequences of PARDS in children remain largely unknown. Multiple studies of adult survivors of ARDS reported adverse long-term effects, including decreased lung function, reduced quality of life and diminished neurocognitive functioning that impacts daily living [120]. The few paediatric studies examining pulmonary function in PARDS survivors are small series with pulmonary function test (PFT) assessments performed at highly variable times after hospital discharge [14, 48, 147]. However, despite the inherent limitations, these uncontrolled studies have indicated abnormalities in PFT persisting for up to 12 years after hospital discharge in a heterogeneous group of PARDS survivors [120]. Importantly, parents also reported more lung problems in a group of 1-6 year olds 3-6 months after discharge from the PICU [85]. These studies underscore that pulmonary function impairments representing both obstructive and restrictive disease do occur in PARDS survivors, necessitating the need for structural follow-up. Recent studies have also begun to focus on the acquisition of new physical deficits and effects on quality of life, mental health and family functioning although these studies are not limited to PARDS patients only [120]. Thus, long-term neuropsychological and cognitive outcomes in children who survive PARDS have not yet been adequately examined.