Altitude and Outcomes in Pediatric ARDS: A Multicenter Study

NCT ID: NCT07193771

Last Updated: 2026-02-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

1600 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-11-01

Study Completion Date

2028-03-31

Brief Summary

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This multicenter observational study will evaluate the association between geographic altitude, availability of critical care resources, and clinical outcomes in children with pediatric acute respiratory distress syndrome (PARDS). Data on demographics, physiology, and hospital structure will be collected from PICUs located at different altitudes worldwide. The study aims to identify gaps in PARDS management and provide recommendations adapted to diverse resource settings.

Detailed Description

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Pediatric acute respiratory distress syndrome (PARDS) is a major cause of admission and mortality in pediatric intensive care units (PICUs). In high-altitude regions, hypoxemia may be exacerbated, complicating diagnostic interpretation and clinical decision-making. At the same time, variability in the availability of advanced resources-such as mechanical ventilation modes, monitoring systems, and trained personnel-could significantly influence outcomes.

This study will prospectively and retrospectively collect clinical, physiological, and institutional data from pediatric cohorts admitted to PICUs situated at different altitudes worldwide. The analysis will explore how altitude and structural resource differences interact with oxygenation and ventilation parameters to affect patient outcomes. The ultimate goal is to generate evidence that supports context-specific guidelines, reduces inequities in critical care delivery, and strengthens pediatric intensive care practices globally.

Conditions

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Respiratory Distress Syndrome, Pediatric Altitude Hypoxia High Altitude Effects

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Low Altitude PICUs

Children with PARDS admitted to pediatric intensive care units located at altitudes between 0-1500 meters above sea level.

Geographic Altitude

Intervention Type OTHER

Participants are grouped according to the altitude of the pediatric intensive care unit (PICU) where they are admitted: low altitude (0-1500 m), intermediate altitude (1501-2500 m), high altitude (2501-3500 m), and very high altitude (\>3500 m). Altitude is treated as the primary exposure variable. No therapeutic intervention is administered as part of this study.

Intermediate Altitude PICUs

Children with PARDS admitted to pediatric intensive care units located at altitudes between 1501-2500 meters above sea level.

Geographic Altitude

Intervention Type OTHER

Participants are grouped according to the altitude of the pediatric intensive care unit (PICU) where they are admitted: low altitude (0-1500 m), intermediate altitude (1501-2500 m), high altitude (2501-3500 m), and very high altitude (\>3500 m). Altitude is treated as the primary exposure variable. No therapeutic intervention is administered as part of this study.

High Altitude PICUs

Children with PARDS admitted to pediatric intensive care units located at altitudes between 2501-3500 meters above sea level.

Geographic Altitude

Intervention Type OTHER

Participants are grouped according to the altitude of the pediatric intensive care unit (PICU) where they are admitted: low altitude (0-1500 m), intermediate altitude (1501-2500 m), high altitude (2501-3500 m), and very high altitude (\>3500 m). Altitude is treated as the primary exposure variable. No therapeutic intervention is administered as part of this study.

Very High Altitude PICUs

Children with PARDS admitted to pediatric intensive care units located at altitudes above 3500 meters above sea level.

Geographic Altitude

Intervention Type OTHER

Participants are grouped according to the altitude of the pediatric intensive care unit (PICU) where they are admitted: low altitude (0-1500 m), intermediate altitude (1501-2500 m), high altitude (2501-3500 m), and very high altitude (\>3500 m). Altitude is treated as the primary exposure variable. No therapeutic intervention is administered as part of this study.

Interventions

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Geographic Altitude

Participants are grouped according to the altitude of the pediatric intensive care unit (PICU) where they are admitted: low altitude (0-1500 m), intermediate altitude (1501-2500 m), high altitude (2501-3500 m), and very high altitude (\>3500 m). Altitude is treated as the primary exposure variable. No therapeutic intervention is administered as part of this study.

Intervention Type OTHER

Other Intervention Names

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Altitude Exposure

Eligibility Criteria

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Inclusion Criteria

* Age between 1 month (corrected gestational age) and 18 years.
* Admission to a pediatric intensive care unit (PICU) or facility where mechanically ventilated children are cared for.
* Requirement of invasive mechanical ventilation.
* Diagnosis of pediatric acute respiratory distress syndrome (PARDS) according to PALICC criteria, confirmed within 24 hours before or after endotracheal intubation.

Exclusion Criteria

* Patients with active perinatal lung disease (e.g., neonatal respiratory distress syndrome, pulmonary hemorrhage, persistent pulmonary hypertension of the newborn, early bronchopulmonary dysplasia, meconium aspiration).
* Patients who have received extracorporeal membrane oxygenation (ECMO) prior to or within the first 24 hours of PARDS diagnosis.
* Patients with pre-established limitation of therapeutic effort (LTE) orders or palliative care directives documented before the initiation of invasive mechanical ventilation.
* Readmissions to the PICU during the study period (only the first episode per patient will be included).
Minimum Eligible Age

1 Month

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universidad Nacional de Colombia

OTHER

Sponsor Role collaborator

Fundación Universitaria de Ciencias de la Salud

OTHER

Sponsor Role collaborator

Latin American Pediatric Collaborative Network

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Clinica Indisa

Santiago, , Chile

Site Status RECRUITING

Hospital Universitario Clinica San Rafael

Bogotá, DC, Colombia

Site Status RECRUITING

Sociedad de Cirugia de Bogota Hospital de San Jose

Bogotá, DC, Colombia

Site Status RECRUITING

Fundación HOMI

Bogotá, DC, Colombia

Site Status RECRUITING

Fundacion Hospital Infantil Los Angeles

Pasto, Departamento de Nariño, Colombia

Site Status RECRUITING

Clínica UROS S.A

Neiva, Huila Department, Colombia

Site Status RECRUITING

Centro Hospitalario Pereira Rossell

Montevideo, Montevideo Department, Uruguay

Site Status RECRUITING

Círculo Católico

Montevideo, , Uruguay

Site Status RECRUITING

Countries

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Chile Colombia Uruguay

Central Contacts

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PABLO VASQUEZ-HOYOS, MD, MSc

Role: CONTACT

573187172029

SEBASTIAN GONZALEZ-DAMBRAUSKAS, MD

Role: CONTACT

59899585225

Facility Contacts

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Victor Monreal, MD

Role: primary

+5693373202

Jennifer Morantes, MD

Role: primary

+573007763472

Pablo Vasquez Hoyos, MD, MSc

Role: primary

57318717-2029

Diana Escobar, MD

Role: primary

+573147045321

Liliana Mazzillo, MD

Role: primary

Ivan Ardila, MD

Role: primary

+573174301866

SEBASTIAN GONZALEZ-DAMBRAUSKAS, MD

Role: primary

+5759899585225

Mónica Decia, MD

Role: primary

+59899664031

References

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Tinoco-Solorzano A, Avila-Hilari A, Avellanas-Chavala ML, Montelongo FJ, Velez-Paez J, Nieto Estrada V, Viruez Soto A, Molano Franco D, Castelo Tamayo E, Granda Luna I, Salazar Mendoza A, Mamani Cruz L, Galindo Ayala J, Vasquez-Hoyos P, Maldonado Coronel F, Huanca Payehuanca R, Sanchez Medina JR. Definitions and consensus recommendations on critical care medicine at altitude from the Expert Committee on Critical Care Medicine at altitude of the Pan-American and Iberian Federation of Critical Care Medicine and Intensive Care. Med Intensiva (Engl Ed). 2025 Oct;49(10):502256. doi: 10.1016/j.medine.2025.502256. Epub 2025 Aug 9.

Reference Type RESULT
PMID: 40784821 (View on PubMed)

Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015 Jun;16(5):428-39. doi: 10.1097/PCC.0000000000000350.

Reference Type RESULT
PMID: 25647235 (View on PubMed)

Molano-Franco D, Masclans Enviz JR, Viruez-Soto A, Gomez M, Rojas H, Beltran E, Nieto V, Aliaga-Raduan F, Iturri P, Arias-Reyes C, Soliz J. Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs. Front Physiol. 2025 Jan 15;15:1520650. doi: 10.3389/fphys.2024.1520650. eCollection 2024.

Reference Type RESULT
PMID: 39882326 (View on PubMed)

Jibaja M, Ortiz-Ruiz G, Garcia F, Garay-Fernandez M, de Jesus Montelongo F, Martinez J, Viruez JA, Baez-Pravia O, Salazar S, Villacorta-Cordova F, Morales F, Tinoco-Solorzano A, Ibanez Guzman C, Valle Pinheiro B, Zubia-Olaskoaga F, Duenas C, Garcia AL, Cardinal-Fernandez P. Hospital Mortality and Effect of Adjusting PaO2/FiO2 According to Altitude Above the Sea Level in Acclimatized Patients Undergoing Invasive Mechanical Ventilation. A Multicenter Study. Arch Bronconeumol (Engl Ed). 2020 Apr;56(4):218-224. doi: 10.1016/j.arbres.2019.06.024. Epub 2019 Sep 30. English, Spanish.

Reference Type RESULT
PMID: 31582181 (View on PubMed)

Related Links

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Other Identifiers

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LARED-001

Identifier Type: -

Identifier Source: org_study_id

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