TY - JOUR T1 - A PEEP/FIO<sub>2</sub> Table in Children With Pediatric ARDS JF - Respiratory Care VL - 66 IS - Suppl 10 SP - 3603412 AU - Herng Lee Tan AU - Yi-Jyun Ma AU - Siew Wah Lee AU - Apollo Bugarin Aguilan AU - Yee Hui Mok AU - Jan Hau Lee AU - Judith Ju-Ming Wong Y1 - 2021/10/01 UR - http://rc.rcjournal.com/content/66/Suppl_10/3603412.abstract N2 - Background: There are limited pediatric data evaluating the use PEEP/FIO2 combinations. We aimed to describe PEEP/FIO2 use in pediatric ARDS (PARDS) patients in relation to a PEEP/FIO2 table modified from the ARDSNet protocol in the first 7 days of PARDS. Methods: Data was utilized post-hoc from a before-and-after comparison study of lung protective mechanical ventilation (MV) strategy in children with PARDS. Time-matched PEEP and FIO2 combinations for the first 7 days of ARDS were described in relation to the protocol. We calculated how far the set PEEP for a given FIO2 was from the protocol recommended PEEP. We took the summative score over the 7 days of PARDS diagnosis for analysis. Logistic regression was used for the main outcome of PICU mortality adjusting for low tidal volume ventilation (3–6mL/kg). Results: We identified 138 children with PARDS who required MV from January 2016 to June 2019. Median OI on day 1 was 10.7 (IQR 7.6–16.6). Patients were on conventional MV on 507/808 (62.8%) of PARDS days. PEEP/FIO2 was within protocol limits for 283/507 (55.8%) days, too low on 150/507 (29.6%) days and too high on 74/507 (14.6%) days. 60/133 (45.1%) patients had a summative PEEP/FIO2 score below that recommended by the modified protocol. A summative score below recommendation was associated with increased PICU mortality [15/60 (25.0%) vs. 13/73 (17.8%); P = 0.311], though this was not statistically significant. After adjustment for low tidal volume ventilation, the summative score was not significantly associated with mortality [odds ratio 0.97 (95% CI 0.90–1.03)]. Conclusions: A PEEP/FIO2 combination table adapted from the ARDSNet protocol in patients with PARDS was adhered to on roughly half of ventilation days, but this was not associated with improved survival. ER -