Pediatric acute respiratory distress syndrome (ARDS) contributes to a significant burden in the PICU of a developing country and is associated with significantly higher mortality.

Infection remains the most common etiology. Higher severity of illness scores at admission, development of pneumothorax, and a positive fluid balance at 48 hours predicted poor outcome. Out of 1,215 children admitted to PICU, 11.4% had pediatric acute respiratory distress syndrome.

45.2% children died. Median age was 2.75 years and 66.9% were male. Most common primary etiologies were pneumonia, severe sepsis, and scrub typhus.

78.2% children were invasively ventilated. All children (age > 1 mo to < 14 yr) admitted in PICU with a diagnosis of pediatric acute respiratory distress syndrome from August 1, 2015, to November 2016.

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