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Paediatrics: how to manage acute respiratory distress syndrome
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a significant cause of mortality and morbidity amongst critically ill children. The purpose of this narrative review is to provide an up-to-date review on the evaluation and management of paediatric ARDS (PARDS). METHODS: A PubMed search was...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioExcel Publishing Ltd
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8177958/ https://www.ncbi.nlm.nih.gov/pubmed/34122589 http://dx.doi.org/10.7573/dic.2021-1-9 |
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author | Hon, Kam Lun Leung, Karen Ka Yan Oberender, Felix Leung, Alexander KC |
author_facet | Hon, Kam Lun Leung, Karen Ka Yan Oberender, Felix Leung, Alexander KC |
author_sort | Hon, Kam Lun |
collection | PubMed |
description | BACKGROUND: Acute respiratory distress syndrome (ARDS) is a significant cause of mortality and morbidity amongst critically ill children. The purpose of this narrative review is to provide an up-to-date review on the evaluation and management of paediatric ARDS (PARDS). METHODS: A PubMed search was performed with Clinical Queries using the key term “acute respiratory distress syndrome”. The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies and reviews. Google, Wikipedia and UpToDate were also searched to enrich the review. The search was restricted to the English literature and children. DISCUSSION: Non-invasive positive pressure ventilation, lung-protective ventilation strategies, conservative fluid management and adequate nutritional support all have proven efficacy in the management of PARDS. The Pediatric Acute Lung Injury Consensus Conference recommends the use of corticosteroids, high-frequency oscillation ventilation and inhaled nitric oxide in selected scenarios. Partial liquid ventilation and surfactant are not considered efficacious based on evidence from clinical trials. CONCLUSION: PARDS is a serious but relatively rare cause of admission into the paediatric intensive care unit and is associated with high mortality. Non-invasive positive pressure ventilation, lung-protective ventilation strategies, conservative fluid management and adequate nutrition are advocated. As there has been a lack of progress in the management of PARDS in recent years, further well-designed, large-scale, randomized controlled trials in this field are urgently needed. |
format | Online Article Text |
id | pubmed-8177958 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioExcel Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-81779582021-06-11 Paediatrics: how to manage acute respiratory distress syndrome Hon, Kam Lun Leung, Karen Ka Yan Oberender, Felix Leung, Alexander KC Drugs Context Review BACKGROUND: Acute respiratory distress syndrome (ARDS) is a significant cause of mortality and morbidity amongst critically ill children. The purpose of this narrative review is to provide an up-to-date review on the evaluation and management of paediatric ARDS (PARDS). METHODS: A PubMed search was performed with Clinical Queries using the key term “acute respiratory distress syndrome”. The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies and reviews. Google, Wikipedia and UpToDate were also searched to enrich the review. The search was restricted to the English literature and children. DISCUSSION: Non-invasive positive pressure ventilation, lung-protective ventilation strategies, conservative fluid management and adequate nutritional support all have proven efficacy in the management of PARDS. The Pediatric Acute Lung Injury Consensus Conference recommends the use of corticosteroids, high-frequency oscillation ventilation and inhaled nitric oxide in selected scenarios. Partial liquid ventilation and surfactant are not considered efficacious based on evidence from clinical trials. CONCLUSION: PARDS is a serious but relatively rare cause of admission into the paediatric intensive care unit and is associated with high mortality. Non-invasive positive pressure ventilation, lung-protective ventilation strategies, conservative fluid management and adequate nutrition are advocated. As there has been a lack of progress in the management of PARDS in recent years, further well-designed, large-scale, randomized controlled trials in this field are urgently needed. BioExcel Publishing Ltd 2021-06-01 /pmc/articles/PMC8177958/ /pubmed/34122589 http://dx.doi.org/10.7573/dic.2021-1-9 Text en Copyright © 2021 Hon KL, Leung KKY, Oberender F, Leung AKC https://creativecommons.org/licenses/by-nc-nd/4.0/Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission. |
spellingShingle | Review Hon, Kam Lun Leung, Karen Ka Yan Oberender, Felix Leung, Alexander KC Paediatrics: how to manage acute respiratory distress syndrome |
title | Paediatrics: how to manage acute respiratory distress syndrome |
title_full | Paediatrics: how to manage acute respiratory distress syndrome |
title_fullStr | Paediatrics: how to manage acute respiratory distress syndrome |
title_full_unstemmed | Paediatrics: how to manage acute respiratory distress syndrome |
title_short | Paediatrics: how to manage acute respiratory distress syndrome |
title_sort | paediatrics: how to manage acute respiratory distress syndrome |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8177958/ https://www.ncbi.nlm.nih.gov/pubmed/34122589 http://dx.doi.org/10.7573/dic.2021-1-9 |
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