This multicenter observational study will evaluate the association between geographic altitude, availability of critical care resources, and clinical outcomes in children with pediatric acute respiratory distress syndrome (PARDS). Data on demographics, physiology, and hospital structure will be collected from PICUs located at different altitudes worldwide. The study aims to identify gaps in PARDS management and provide recommendations adapted to diverse resource settings.
Pediatric acute respiratory distress syndrome (PARDS) is a major cause of admission and mortality in pediatric intensive care units (PICUs). In high-altitude regions, hypoxemia may be exacerbated, complicating diagnostic interpretation and clinical decision-making. At the same time, variability in the availability of advanced resources-such as mechanical ventilation modes, monitoring systems, and trained personnel-could significantly influence outcomes. This study will prospectively and retrospectively collect clinical, physiological, and institutional data from pediatric cohorts admitted to PICUs situated at different altitudes worldwide. The analysis will explore how altitude and structural resource differences interact with oxygenation and ventilation parameters to affect patient outcomes. The ultimate goal is to generate evidence that supports context-specific guidelines, reduces inequities in critical care delivery, and strengthens pediatric intensive care practices globally.
Study Type
OBSERVATIONAL
Enrollment
1,600
Participants are grouped according to the altitude of the pediatric intensive care unit (PICU) where they are admitted: low altitude (0-1500 m), intermediate altitude (1501-2500 m), high altitude (2501-3500 m), and very high altitude (\>3500 m). Altitude is treated as the primary exposure variable. No therapeutic intervention is administered as part of this study.
Hospital del Niño Sor Teresa Huarte Tama
Sucre, Chuquisaca Department, Bolivia
RECRUITINGClinica Indisa
Santiago, Chile
RECRUITINGHospital Universitario Clinica San Rafael
Bogotá, DC, Colombia
RECRUITINGSociedad de Cirugia de Bogota Hospital de San Jose
Bogotá, DC, Colombia
RECRUITINGFundación HOMI
Bogotá, DC, Colombia
RECRUITINGFundacion Hospital Infantil Los Angeles
Pasto, Departamento de Nariño, Colombia
RECRUITINGClínica UROS S.A
Neiva, Huila Department, Colombia
RECRUITINGLaCardio
Bogotá, Colombia
NOT_YET_RECRUITINGHospital Nacional Adolfo Guevara Velasco
Cusco, Peru
RECRUITINGCentro Hospitalario Pereira Rossell
Montevideo, Montevideo Department, Uruguay
RECRUITING...and 1 more locations
In-hospital mortality
Proportion of patients with PARDS who die during hospitalization. Mortality is defined as death during the same hospitalization period in which PARDS was diagnosed.
Time frame: From PICU admission until hospital discharge (up to 90 days)
New morbidity at hospital discharge
Presence of new functional morbidity measured using Functional Status Score greater than 2.
Time frame: From PICU admission until hospital discharge (up to 90 days)
Ventilator-free days at 28 days.
Defined as the number of days a patient is alive and free from invasive mechanical ventilation during the first 28 days after initiation of ventilation. Patients who die within 28 days of initiation will be assigned a value of 0. For survivors, ventilator-free days will be calculated as 28 minus the total number of days on invasive mechanical ventilation during this period.
Time frame: 28 days after initiation of invasive mechanical ventilation
ICU-free days at 28 days.
Defined as the number of days a patient is alive and not admitted to the ICU during the first 28 days after ICU admission. Patients who die within 28 days of ICU admission will be assigned a value of 0. For survivors, ICU-free days will be calculated as 28 minus the total number of days spent in the ICU during this period.
Time frame: 28 days after ICU admission
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