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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...

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Autores principales: Hon, Kam Lun, Leung, Karen Ka Yan, Oberender, Felix, Leung, Alexander KC
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioExcel Publishing Ltd 2021
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.
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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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