Pathophysiology and Management of Acute Respiratory Distress Syndrome in Children

Sabrina M Heidemann; Alison Nair; Yonca Bulut; Anil Sapru

doi:10.1016/j.pcl.2017.06.004

Pathophysiology and Management of Acute Respiratory Distress Syndrome in Children

Pediatr Clin North Am. 2017 Oct;64(5):1017-1037. doi: 10.1016/j.pcl.2017.06.004.

Authors

Sabrina M Heidemann¹, Alison Nair², Yonca Bulut³, Anil Sapru⁴

Affiliations

¹ Department of Pediatrics, Wayne State University, Detroit, MI 48202, USA.
² Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0110 San Francisco, CA 94143, USA.
³ Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
⁴ Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0110 San Francisco, CA 94143, USA; Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. Electronic address: asapru@mednet.ucla.edu.

Abstract

Acute respiratory distress syndrome (ARDS) is a syndrome of noncardiogenic pulmonary edema and hypoxia that accompanies up to 30% of deaths in pediatric intensive care units. Pediatric ARDS (PARDS) is diagnosed by the presence of hypoxia, defined by oxygenation index or Pao₂/Fio₂ ratio cutoffs, and new chest infiltrate occurring within 7 days of a known insult. Hallmarks of ARDS include hypoxemia and decreased lung compliance, increased work of breathing, and impaired gas exchange. Mortality is often accompanied by multiple organ failure. Although many modalities to treat PARDS have been investigated, supportive therapies and lung protective ventilator support remain the mainstay.

Keywords: Acute lung injury; Acute respiratory distress syndrome; PARDS; Pathophysiology; Pediatrics.

Publication types

Review

MeSH terms

Acute Disease
Child
Combined Modality Therapy
Critical Care / methods*
Diet Therapy
Extracorporeal Circulation
Fluid Therapy / methods
Humans
Respiration, Artificial / adverse effects
Respiration, Artificial / methods
Respiratory Insufficiency / physiopathology*
Respiratory Insufficiency / therapy*
Syndrome

Abstract

Publication types

MeSH terms

Grants and funding