Epidemiological, Clinical and Therapeutic Aspects of Acute Respiratory Distress in Children in Medical Emergencies at the Bangui Pediatric University Hospital
Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.
References
[1]
Lodé, N., Chabernaud, J.L. and Marguet, C. (2016) Détresse respiratoire aiguë de l’enfant. In: Lavoisier Médecine Sciences Ed., Urgences respiratoires, Actualités en médecine, 203-254. https://www.researchgate.net/publication/305479091
[2]
Chabernaud, J.L. and Lebars, G. (2009) Détresse respiratoire de l’enfant, 51e congrès national d’anesthésie et de réanimation, Paris, 23 au 26 septembre 2009, 1-8.
[3]
Les détresses respiratoires en pédiatrie. https://www.soins-infirmier.com/
[4]
Dahlem, P., van Aalderen, W.M.C. and Bos, A.P. (2007) Pediatric Acute Lung Injury. PaediatricRespiratoryReviews, 8, 348-362. https://doi.org/10.1016/j.prrv.2007.03.001
[5]
López-Fernández, Y., Martínez-de Azagra, A., de la Oliva, P., Modesto, V., Sánchez, J.I., Parrilla, J., et al. (2012) Pediatric Acute Lung Injury Epidemiology and Natural History Study: Incidence and Outcome of the Acute Respiratory Distress Syndrome in Children. CriticalCareMedicine, 40, 3238-3245. https://doi.org/10.1097/ccm.0b013e318260caa3
[6]
Schouten, L.R.A., Veltkamp, F., Bos, A.P., van Woensel, J.B.M., Serpa Neto, A., Schultz, M.J., etal. (2016) Incidence and Mortality of Acute Respiratory Distress Syndrome in Children. CriticalCareMedicine, 44, 819-829. https://doi.org/10.1097/ccm.0000000000001388
[7]
Wong, J.J., Loh, T.F., Testoni, D., Yeo, J.G., Mok, Y.H. and Lee, J.H. (2014) Epidemiology of Pediatric Acute Respiratory Distress Syndrome in Singapore: Risk Factors and Predictive Respiratory Indices for Mortality. FrontiersinPediatrics, 2, Article 78. https://doi.org/10.3389/fped.2014.00078
[8]
Daffe, H. (2006) Urgences pédiatriques au service de pédiatrie de l’hôpital régional Nianankoro Fomba de Ségou. Thèse Méd. Université des Sciences, des Techniques et des Technologies de Bamako.
[9]
Maiga, B., Togo, B., Diall, H., Togo, P., Doumbia, A., Sacko, K., etal. (2016) Etude épidémiologique et clinique des détresses respiratoires aigues chez les enfants âgés de 1 à 59 mois admis dans le service des urgences pédiatriques au CHU Gabriel Toure. Revue Malienne d’Infectiologie et de Microbiologie, 7, 27-32. https://doi.org/10.53597/remim.v0i0.894
[10]
Diop, A. (2018) Study of the épidémiologique, clinical, radiological and evolutionary characteristics of acute lower respiratory infections. Medical Thesis, The Pediatrics Department of the CHN of Pikine, Senegal.
[11]
Biarent, D., Bingham, R., Alouini, S., et al. (2010) European Paediatric Immediate Life Support. ERC, 2-3.
[12]
Sawadogo, S., Sanou, I., Reinhardt, M., et al. (1997) La bronchiolite aigue du nourrisson en milieu hospitalier pédiatrique sahélien. Annales de Pédiatrie, 44, 894-896.
[13]
Chabernaud, J.L., Claudet, I., Lodé, N., Daussac, E., Rebouissoux, L. and Ayachi, A. (2016) Urgences pédiatriques. Guide de poche. 2e Édition, Maloine.
[14]
Pigne, E., Aubier, M., Godeau, P., Hersons, S. and Piette, J.C. (2014) Insuffisance respiratoire aigüe. In: Collectif, Guillevin, L., Mouthon, L., Lévesque, H. and Godeau, P., Eds., Traité de médecine, 6e Édition, Flammarion, 1076-1078.
[15]
Labrousse, J. and Goulon, M. (2013) Insuffisance respiratoire aigüe, In: Réanimation médicale, 5e Edition, Masson, 73-84.
[16]
Maitland, K., Kiguli, S., Opoka, O.R., Olupot, O.P., Engoru, C., Njuguna, P., et al. (2018) Essai sur les stratégies d’administration de l’oxygène chez les enfants (COAST): Essai contrôlé randomisé de haut débit versus oxygène versus contrôle chez les enfants africains atteints de pneumonie grave. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771148/
[17]
Bourillon, A. (2014) Détresse respiratoire aigüe chez le nourrisson et l’enfant. In: de Grégoire, B., Antoine, B., Christophe, D, et al., Eds., Pédiatrie: Les référentiels des collèges. Elsevier Masson, 409-420.
[18]
Trésor, T.M. (2013) Profil clinique, étiologique et thérapeutique de la détresse respiratoire néonatale. Thèse Doct-Méd, Université Kongo RDC.
[19]
Mishra, S., Kumar, H., Anand, V.K., Patwari, A.K. and Sharma, D. (1993) ARI Control Programme: Results in Hospitalized Children. JournalofTropicalPediatrics, 39, 288-292. https://doi.org/10.1093/tropej/39.5.288
[20]
Sung, R.Y.T., Cheng, A.F.B., Chan, R.C.K., Tarn, J.S. and Oppenheimer, S.J. (1993) Epidemiology and Etiology of Pneumonia in Children in Hong Kong. ClinicalInfectiousDiseases, 17, 894-896. https://doi.org/10.1093/clinids/17.5.894