{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:32:48Z","timestamp":1788431568794,"version":"build-2803163510"},"reference-count":42,"publisher":"American Academy of Pediatrics (AAP)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Acute respiratory failure recalcitrant to conventional management often requires specialized organ-supportive technologies to optimize outcomes. Variation in the availability of these technologies prompted testing of the hypothesis that outcomes and resource use will vary by not only patient characteristics but also hospital characteristics and receipt of organ-supportive technology.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Retrospective study of children 0 to 20 years old hospitalized for acute respiratory failure using the 2019 Kids\u2019 Inpatient Database. Multivariable regression models identified factors associated with mortality, length of hospitalization, and costs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of an estimated 75\u2009365 hospitalizations nationally, 97% were to urban teaching hospitals, 57% were of children &amp;lt; 6 years, and 58% were of males. Complex chronic conditions (CCC) existed in 62%, multiorgan dysfunction in 35%, and extreme illness severity in 54%. Mortality was 7%, length of stay 15 days, and hospital costs $77\u2009168. Elevated mortality was associated with cumulative organ dysfunction (odds ratio [OR]:2.31, 95% confidence interval [CI]: 2.22\u20132.42), CCC (OR: 5.49, 95% CI: 4.73\u20136.37), transfer, higher illness severity, and cardiopulmonary resuscitation. Lower mortality was associated with extracorporeal membrane oxygenation (OR: 0.36, 95% CI: 0.28\u20130.47) and new tracheostomy (OR: 0.30, 95% CI: 0.25\u20130.35). Longer hospitalization was associated with transfer, infancy, CCC, higher illness severity, cumulative organ dysfunction, and urban hospitals. Higher costs accrued with noninfants, cumulative organ dysfunction, private insurance, and urban teaching hospitals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Hospitalizations for pediatric acute respiratory failure incurred substantial mortality and resource consumption. Efforts to reduce mortality and resource consumption should address interhospital transfer, access to organ-supportive technology, and drivers of higher severity-adjusted resource consumption at urban hospitals.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2023-007166","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T08:11:45Z","timestamp":1719907905000},"page":"622-631","source":"Crossref","is-referenced-by-count":7,"title":["Epidemiology of Acute Respiratory Failure in US Children: Outcomes and Resource Use"],"prefix":"10.1542","volume":"14","author":[{"given":"Folafoluwa O.","family":"Odetola","sequence":"first","affiliation":[{"name":"aDivision of Pediatric Critical Care Medicine, Department of Pediatrics"},{"name":"bChild Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achamyeleh","family":"Gebremariam","sequence":"additional","affiliation":[{"name":"bChild Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2024,7,2]]},"reference":[{"issue":"7","key":"2024080102513519800_B1","doi-asserted-by":"crossref","first-page":"e268","DOI":"10.3928\/19382359-20180625-01","article-title":"Acute respiratory failure in children","volume":"47","author":"Friedman","year":"2018","journal-title":"Pediatr Ann"},{"issue":"12","key":"2024080102513519800_B2","doi-asserted-by":"crossref","first-page":"3238","DOI":"10.1097\/CCM.0b013e318260caa3","article-title":"Pediatric acute lung injury epidemiology and natural history study: incidence and outcome of the acute respiratory distress syndrome in children","volume":"40","author":"L\u00f3pez-Fern\u00e1ndez","year":"2012","journal-title":"Crit Care Med"},{"issue":"2","key":"2024080102513519800_B3","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S2213-2600(18)30344-8","article-title":"Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study","volume":"7","author":"Khemani","year":"2019","journal-title":"Lancet Respir Med"},{"issue":"4","key":"2024080102513519800_B4","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1097\/CCM.0000000000001388","article-title":"Incidence and mortality of acute respiratory distress syndrome in children: a systematic review and meta-analysis","volume":"44","author":"Schouten","year":"2016","journal-title":"Crit Care Med"},{"issue":"7","key":"2024080102513519800_B5","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1177\/0885066617705109","article-title":"Mortality in pediatric acute respiratory distress syndrome: a systematic review and meta-analysis","volume":"34","author":"Wong","year":"2019","journal-title":"J Intensive Care Med"},{"key":"2024080102513519800_B6","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.jcrc.2016.09.022","article-title":"Interhospital transfer of children in respiratory failure: a clinician interview qualitative study","volume":"37","author":"Odetola","year":"2017","journal-title":"J Crit Care"},{"issue":"4","key":"2024080102513519800_B7","first-page":"317","article-title":"Acute lung injury in pediatric intensive care in Australia and New Zealand: a prospective, multicenter, observational study","volume":"8","author":"Erickson","year":"2007","journal-title":"Pediatr Crit Care Med"},{"key":"2024080102513519800_B8","volume-title":"HCUP Kids\u2019 Inpatient Database (KID). 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