New concepts in the treatment of children with acute respiratory distress syndrome

Paulson, Thomas E.; Spear, Robert M.; Peterson, Bradley M.

doi:10.1016/s0022-3476(95)70291-1

Cited by 53 publications

(13 citation statements)

References 97 publications

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“…12 At a given degree of lung disease, a high PEEP would probably result in improvement in PaO 2 at any FI,O 2 , thereby reducing the P(A-a),O2 gradient. 13 Hence, variables such as the VI, which incorporates a factor measuring the intensity of therapy, are important components of any prediction model. …”

Section: Discussionmentioning

confidence: 99%

Ventilation index and outcome in children with acute respiratory distress syndrome

et al. 1998

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The purpose of this investigation was to determine the predictive value of the ventilation index (VI) in children with acute respiratory distress syndrome (ARDS). We performed a 10‐year retrospective chart review of children who were admitted to the Pediatric Intensive Care Unit with a diagnosis of ARDS. Acute respiratory distress syndrome was defined as acute onset of diffuse, bilateral pulmonary infiltrates of noncardiac origin, and severe hypoxemia, defined as the ratio of the arterial partial pressure of oxygen to the fraction of inspired oxygen of <200 and a positive end expiratory pressure of 6 cmH2O or greater. Records of daily arterial blood gas results and ventilator settings were reviewed, and the ventilation index (VI = partial pressure of arterial CO2 × peak airway pressure × respiratory rate/1,000) was calculated each time the measurements were made. These values were correlated with outcome (survival or nonsurvival). The VI was not different at the time of diagnosis of ARDS in the patients who lived, compared with those who subsequently died. However, by 3 to 5 days after study entry, the VI of nonsurvivors was significantly higher than for survivors (P < 0.05). The VI for survivors remained between 30 and 35 throughout the study period, whereas the VI of nonsurvivors continued to increase with time. A VI of >65 predicted death with a specificity and positive predictive value of >90% on days 3 through 9. We conclude that the VI provides a reliable prognostic marker in children with ARDS, and its increase above 65 indicates a need for orderly intervention with alternative modalities of care. Pediatr Pulmonol. 1998; 26:125–128. © 1998 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Ventilation index and outcome in children with acute respiratory distress syndrome

et al. 1998

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“…The rate of accidental extubation was 0.5 cases per 100 intubated days. One patient with bacterial tracheitis died due to severe acute respiratory distress syndrome (ARDS) [14].…”

Section: All Patientsmentioning

confidence: 99%

The outcome of patients with upper airway obstruction transported to a regional paediatric intensive care unit

Durward¹,

Nicoll²,

Oliver³

et al. 1998

European Journal of Pediatrics

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“…The acute phase of ARDS is characterized by hyperinflammation with excessive pulmonary sequestration of polymorphonuclear leukocytes (PMNL) in their metabolically activated state (9,10). Critical to this inflammatory process is the activation of nuclear factor (NF)-B, a transcription factor that is required for transcription of the genes for many proinflammatory mediators (11,12).…”

mentioning

confidence: 99%

Surfactant “fortification” by topical inhibition of nuclear factor-κB activity in a newborn piglet lavage model*

Bismarck

Klemm

Wistädt

et al. 2007

Critical Care Medicine

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New concepts in the treatment of children with acute respiratory distress syndrome

Cited by 53 publications

References 97 publications

Ventilation index and outcome in children with acute respiratory distress syndrome

Ventilation index and outcome in children with acute respiratory distress syndrome

The outcome of patients with upper airway obstruction transported to a regional paediatric intensive care unit

Surfactant “fortification” by topical inhibition of nuclear factor-κB activity in a newborn piglet lavage model*

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