Dead Space and Inhaled Nitric Oxide in Pediatric Acute Respiratory Distress Syndrome

Number of participants that experience all-cause mortality within 90 days from start of invasive mechanical ventilation

90 day all-cause mortality

Time frame: From the start of invasive mechanical ventilation to 90 days

28-Day Ventilator-Free Days

The number of days within the first 28 days of invasive mechanical ventilation for ARDS that a patient is alive and free of mechanical ventilation.

Time frame: From the start of invasive mechanical ventilation to 28 days

The days on invasive mechanical ventilation for survivors of ARDS

The number of days that a patient that survives is on invasive mechanical ventilation (up to 90 days)

Time frame: From the start of invasive mechanical ventilation to the end of invasive mechanical ventilation (or 90 days after the start of invasive mechanical ventilation if the patient is still on invasive mechanical ventilation at 90 days)

The number of non-pulmonary organ failure free days within the first 14 days of invasive mechanical ventilation

Organ failure criteria will be determined with the Pediatric Organ Dysfunction Information Update Mandate. We will identify the number of days in the first 14 days of ARDS that a patient is alive and without any non-pulmonary organ failures.

Time frame: From the start of invasive mechanical ventilation to 14 days

The number of non-pulmonary organ failures 21 days after the start of invasive mechanical ventilation

Organ failure criteria will be determined with the Pediatric Organ Dysfunction Information Update Mandate. The number of non-pulmonary organ failures on day 21 after the start of invasive mechanical ventilation will be identified. Patients that experience mortality prior to 21 days will be considered to have failure of all non-pulmonary organs.

Time frame: 21 days after the start of invasive mechanical ventilation

The number of non-pulmonary organ failures 28 days after the start of invasive mechanical ventilation

Organ failure criteria will be determined with the Pediatric Organ Dysfunction Information Update Mandate. The number of non-pulmonary organ failures on day 28 after the start of invasive mechanical ventilation will be identified. Patients that experience mortality prior to 28 days will be considered to have failure of all non-pulmonary organs.

Time frame: 28 days after the start of invasive mechanical ventilation

The number of non-pulmonary organs that newly meet failure criteria or have an increase in the severity of organ failure within the first 14 days of invasive mechanical ventilation

Organ failure criteria will be determined with the Pediatric Organ Dysfunction Information Update Mandate. We will identify the number of organs during the first 14 days of invasive mechanical ventilation that either have worsening of the severity of failure or new failure after the first day of invasive mechanical ventilation.

Time frame: From the start of invasive mechanical ventilation to 14 days

The development of renal failure within the first 14 days of invasive mechanical ventilation

Renal organ failure criteria will be determined with the Pediatric Organ Dysfunction Information Update Mandate. We will identify whether during the first 14 days of invasive mechanical ventilation there is new renal failure after the first day of invasive mechanical ventilation.

Time frame: From the start of invasive mechanical ventilation to 14 days

Non-pulmonary organ failure phenotypes that develop within the first 14 days of invasive mechanical ventilation

Organ failure criteria will be determined with the Pediatric Organ Dysfunction Information Update Mandate. We will identify 14-day non-pulmonary organ failure free phenotypes using clustering analyses.

Time frame: From the start of invasive mechanical ventilation to 14 days

Cumulative non-pulmonary organ failure severity in the first 14 days of invasive mechanical ventilation

Organ failure scores will be quantified daily with the Pediatric Logistic Organ Dysfunction (PELOD-2) score. Children that die will be assigned the maximum value. The score will be summed over the first 14 days of invasive mechanical ventilation.

Time frame: From the start of invasive mechanical ventilation to 14 days

The change in functional status score from baseline to hospital discharge

The baseline functional status score and the intensive care unit discharge functional status score will be compared and new morbidities will be identified. If the patient is still in the hospital after 90 days of the start of invasive mechanical ventilation the functional status score at 90 days will be used rather than the functional status score at hospital discharge.

Time frame: From baseline to hospital discharge (or 90 days after the start of invasive mechanical ventilation)

The change in pediatric overall performance score from baseline to hospital discharge

The baseline pediatric overall performance score and the hospital discharge pediatric overall performance score will be compared and new morbidities will be identified. If the patient is still in the hospital after 90 days of the start of invasive mechanical ventilation the pediatric overall performance score at 90 days will be used rather than the pediatric overall performance score at hospital discharge.

Time frame: From baseline to hospital discharge (or 90 days after the start of invasive mechanical ventilation)

The change in pediatric cerebral performance score from baseline to hospital discharge

The baseline pediatric cerebral performance score and the hospital discharge pediatric cerebral performance score will be compared and new morbidities will be identified. If the patient is still in the hospital after 90 days of the start of invasive mechanical ventilation the pediatric cerebral performance score at 90 days will be used rather than the pediatric cerebral performance score at hospital discharge.

Time frame: From baseline to hospital discharge (or 90 days after the start of invasive mechanical ventilation)

All-cause mortality or the use of extracorporeal membrane oxygenation (ECMO) therapy within 28 days after the start of invasive mechanical ventilation

Patients who experience mortality or use of ECMO within 28 days of the start of invasive mechanical ventilation

Time frame: From the start of invasive mechanical ventilation to 28 days