Special considerations for the management of pediatric acute respiratory distress syndrome

• Published in: Expert review of respiratory medicine Vol. 10; no. 10; p. 1133
• Main Authors: Lim, Joel Kian Boon, Lee, Jan Hau, Cheifetz, Ira M
• Format: Journal Article
• Language: English
• Published: England 02-10-2016
• Subjects: Acute Lung Injury - therapy; Age Factors; Child; Humans; Patient Selection; Respiratory Distress Syndrome, Adult - therapy; Acute respiratory distress syndrome; corticosteroids; high frequency oscillatory ventilation; children; outcomes; definition; pediatric
• ISSN: 1747-6356
• DOI: 10.1080/17476348.2016.1219656

Pediatric acute respiratory distress syndrome (ARDS) remains a diagnostic and therapeutic challenge with significant mortality and morbidity. There are limited data to guide identification and management.
The Pediatric Acute Lung Injury Consensus Conference recently proposed pediatric-specific definitions for ARDS and management recommendations. In this review, we discuss aspects of pediatric ARDS that have received more attention over the past few years: high frequency oscillatory ventilation, administration of corticosteroids and functional outcomes. We conducted searches on PubMed, ClinicalKey and Google Scholar using medical subject heading terms and text words related to acute lung injury and ARDS. Expert commentary: The newly proposed definition for pediatric ARDS requires validation for efficacy in diagnosis and risk stratification. At present, there is insufficient evidence to support routine use of high frequency oscillatory ventilation or corticosteroids in pediatric ARDS. Further studies are required to determine the impact of pediatric ARDS on functional outcomes.