Pediatric acute respiratory distress syndrome: How to protect the lungs during mechanical ventilation?

Abstract

Pediatric acute respiratory distress syndrome (PARDS) is a frequent diagnosis in critical care. This inflammatory process has different stages characterized by mild-to-severe hypoxia, and the management will vary according to the severity. New definitions for pediatric patients were published in 2015; new epidemiological evidence revising those definitions has helped understand the mortality associated with PARDS and the impact on ventilation. The strategies to protect the lungs during mechanical ventilation have been successful in reducing mortality and complications. In clinical situations where high levels of critical support are limited, other therapies with a lower level of evidence can be attempted to gain time without worsening the ongoing pulmonary injury. We offer a complete narrative revision of this syndrome, with the critical management of these patients as a priority.

Prone position in the mechanical ventilation of acute respiratory distress syndrome children: a systematic review and meta-analysis

“…The analysis of the causes may be related to the different severity and prognosis of children and adults with ARDS. Therefore, the appropriate ventilation time, turning times and treatment course of children with ARDS in prone position cannot refer to the standard of adult patients, which needs to be further evaluated in the future ( 42 , 43 ).…”