Background: Few epidemiological studies on pediatric acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) have been published. This investigation aimed to understand clinical epidemiological situation of ALI and ARDS in China.

Methods: A series of 64 patients with ALI hospitalized at the pediatric intensive care unit (PICU) of our hospital from February 1996 to January 2001 was analyzed by case-control study. Six death risk factors were studied by single-factor relative risk analysis.

Results: All 64 patients accounted for 0.084% of total hospital admissions and 3.77% of critically ill patients at the PICU during the same period, with an increased morbidity and a mortality of 34.38%. In primary intra-pulmonary diseases, pneumonia was predominant, followed by inhalation. Extra-pulmonary diseases were mainly due to sepsis and heat-stroke syndrome. The order of 6 death risk factors included systemic inflammatory response syndrome (SIRS), extra-pulmonary organ dysfunction, PaO2/FiO2≤200, sepsis, critically ill score ≤70, and pneumonia.

Conclusions: The morbidity of ALI/ARDS is increasing because of improved recognition and diagnosis of the disease. The mortality remains high, while SIRS developing into multiple organ dysfunction syndrome is a high-risk factor causing death.