Abstract
The Pediatric Acute Lung Injury Consensus Conference (PALICC) has provided the critical care community with the first pediatric-focused definition for ARDS. The PALICC recommendations provide guidance on conventional ventilator management, gas exchange goals, use of high-frequency ventilation, adjunct management approaches, and the application of extracorporeal membrane oxygenation for pediatric ARDS (PARDS). Although outcomes for PARDS have improved over the past decade, mortality and morbidity remain significant. Pediatric-specific criteria may provide the ability to more promptly recognize and diagnose PARDS in clinical practice. Improvements in prognostication and stratification of disease severity may help to guide therapeutic interventions. Improved comparisons between patients and studies may help to promote future clinical investigations. Hopefully, the recommendations provided by PALICC, in terms of defining and managing ARDS, will stimulate additional research to better guide therapy and further improve outcomes for critically ill infants and children with ARDS.
- ARDS
- pediatric
- high-frequency oscillatory ventilation
- outcome
- children
- hypoxemia
- hypoxia
- ventilator-induced lung injury
- prone positioning
- nitric oxide
- surfactant
- extracorporeal membrane oxygenation
Footnotes
- Correspondence: Ira M Cheifetz MD FAARC, Division of Pediatric Critical Care Medicine, Duke University Medical Center, Box 3046, Durham, NC 27710. E-mail: ira.cheifetz{at}duke.edu.
Dr Cheifetz discloses relationships with Philips and Up-to-Date.
Dr Cheifetz presented a version of this paper at the 55th Respiratory Care Journal Conference, “Pediatric Respiratory Care,” held June 10-11, 2016, in St Petersburg, Florida.
↵* Timothy R Myers MBA RRT-NPS FAARC, invited discussant. Mr Myers is the Chief Business Officer, American Association for Respiratory Care.
↵† Richard D Branson MSc RRT FAARC, Deputy Editor, Respiratory Care.
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