AI Article Synopsis
- The RALE score effectively quantifies lung edema and serves as a promising prognostic marker for mortality in children suffering from acute respiratory distress syndrome (ARDS).
- Among 296 children studied, the RALE score demonstrated strong reliability and was correlated with other indicators of ARDS severity, indicating its potential as a useful tool in clinical settings.
- The study found that a higher RALE score is linked to increased ARDS-specific mortality, allowing clinicians to make better-informed decisions regarding treatment and fluid management for affected children.
Article Abstract
Purpose: The radiographic assessment of lung edema (RALE) score enables objective quantification of lung edema and is a valuable prognostic marker of adult acute respiratory distress syndrome (ARDS). We aimed to evaluate the validity of RALE score in children with ARDS.
Materials And Methods: The RALE score was measured for its reliability and correlation to other ARDS severity indices. ARDS-specific mortality was defined as death from severe pulmonary dysfunction or the need for extracorporeal membrane oxygenation therapy. The C-index of the RALE score and other ARDS severity indices were compared via survival analyses.
Results: Among 296 children with ARDS, 88 did not survive, and there were 70 ARDS-specific non-survivors. The RALE score showed good reliability with an intraclass correlation coefficient of 0.809 [95% confidence interval (CI), 0.760-0.848]. In univariable analysis, the RALE score had a hazard ratio (HR) of 1.19 (95% CI, 1.18-3.11), and the significance was maintained in multivariable analysis adjusting with age, ARDS etiology, and comorbidity, with an HR of 1.77 (95% CI, 1.05-2.91). The RALE score was a good predictor of ARDS-specific mortality, with a C-index of 0.607 (95% CI, 0.519-0.695).
Conclusion: The RALE score is a reliable measure for ARDS severity and a useful prognostic marker of mortality in children, especially for ARDS-specific mortality. This score provides information that clinicians can use to decide the proper time of aggressive therapy targeting severe lung injury and to appropriately manage the fluid balance of children with ARDS.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232997 | PMC |
| http://dx.doi.org/10.3349/ymj.2022.0653 | DOI Listing |
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