Objectives: Although the mortality rate of pediatric acute respiratory distress syndrome (PARDS) continues to decrease, the increased incidence of clinical sequelae in survivors has become a focus of clinical practice. This study aimed to determine the functional status of PARDS survivors at hospital discharge using the Functional Status Scale and to identify risk factors associated with mortality. Methods: We retrospectively analyzed the clinical data of patients with PARDS assessed upon admission and discharge from our hospital’s pediatric intensive care unit between January 2013 and January 2020. Patients were categorized into survival and non-survival groups for intergroup clinical characteristics and therapeutic intervention comparisons. Results: Of the 149 study participants, 96 (64.4%) died during hospitalization, and 53 (35.6%) survived until discharge. Severe PARDS, defined as an oxygenation index score of ≥16, was an independent risk factor for mortality. Although surviving participants showed improvements in their clinical status, the new morbidity rate at discharge was 24.5%, with respiratory, feeding, and motor functions being the domains most affected. Conclusion: Severe PARDS was an independent risk factor for mortality. Despite the PARDS survival rate for the participants being 33.33%, approximately a quarter of survivors experienced new morbidities after discharge. The most affected functions included those related to respiration, feeding, and motor activity; therefore, special attention should be given to maintaining these functions in survivors.

Mycoplasma (M.) pneumoniae is a common pathogen causing respiratory infections in children. Pulmonary embolism is a rare complication that may be life-threatening if not diagnosed early and treated promptly. Here, we report the case of an 11-year-old patient with pulmonary embolism associated with M. pneumoniae pneumonia. The patient developed uncorrectable hypoxemia and received venovenous extracorporeal membrane oxygenation treatment. Although the mechanism of thrombosis after M. pneumoniae infection remains unknown, an increase in the cold agglutinin titer indicates that cold agglutinin syndrome might be the mechanism of this pathological change. We thought that patients who have positive cold agglutinin after M. pneumoniae infection should be monitored for the possibility of thrombosis formation.

Mycoplasma (M.) pneumoniae is a common pathogen causing respiratory infections in children. Pulmonary embolism is a rare complication that may be life-threatening if not diagnosed early and treated promptly. Here, we report the case of an 11-year-old patient with pulmonary embolism associated with M. pneumoniae pneumonia. The patient developed uncorrectable hypoxemia and received venovenous extracorporeal membrane oxygenation treatment. Although the mechanism of thrombosis after M. pneumoniae infection remains unknown, an increase in the cold agglutinin titer indicates that cold agglutinin syndrome might be the mechanism of this pathological change. Finally, the patient was cured with antibiotic and anticoagulant therapies. Patients who have significantly increased C-reactive protein and D-dimer levels and positive cold agglutinin after M. pneumoniae infection should be monitored for the possibility of thrombosis formation.