Pediatric Ards: Clinician Recognition Since the Release of the Pediatric Acute Lung Injury Consensus Conference Definition

Rufener, Christina; Kopstick, Avi; Orwoll, Benjamin

doi:10.1016/j.chest.2020.08.1612

Cited by 2 publications

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“…Due to the limitations of previous definitions when applied to pediatric population, the Pediatric Acute Lung Injury Consensus Conference (PALICC) published in 2015 a pediatric-specific definition for ARDS [ 4 ]. However, mortality remains high in PARDS and in 2020, an investigation conducted by Christina Rufener revealed a failure in PARDS diagnosing which may have impact on PARDS outcome [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Pediatric acute respiratory distress syndrome in a Moroccan intensive care unit: a retrospective observational study of 23 cases

Benlamkaddem¹,

Bouyerman²,

Berdaï³

et al. 2023

Pan Afr Med J

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Acute respiratory distress syndrome (ARDS) is a life-threatening condition despite medical development. Unlike adult, ARDS, in pediatric population, has been recently defined in the Pediatric Acute Lung Injury Consensus Conference (PALICC), 2015. We conduct a retrospective descriptive study, in pediatric intensive care unit (PICU) of Hassan II University Hospital during a period of 2 years (2019 to 2021) in which we included 23 pediatric cases of ARDS defined using 2012 Berlin criteria. They represent 2.7% of all patients admitted in our unit (23 patients of 850 admissions), with a male predominance 17 males/6 females, the median of age was 4.6 years-old (2 months to 14 years-old). Pediatric acute respiratory distress syndrome (PARDS) cases were stratified as mild in 13% (n=3), moderate in 52% (n=12), and severe in 35% (n=8). The etiologies were of pulmonary origin (pneumonia, aspiration, pulmonary contusion, and foreign body) in 79% of cases (n=18), and extra-pulmonary origin (sepsis, burn and major trauma) in 21% (n=5). The management was based on lung protective invasive mechanical ventilation (95%, n=22), Prone positioning was applied (26%, n=6), inhaled nitric oxide (iNO) was used in (35%, n=8), recruitment maneuvers (56%, n=13), neuromuscular blockade (NMB) (74%, n=17) and extracorporeal membrane oxygenation (ECMO) in 1 case. The outcome was favorable in 65% (n=15) with a mean PICU-stay of 20 days (SD=16 days). Overall mortality rate was 35% (n=8), and 100% (n=5) in case of extrapulmonary (indirect) etiologies. It was proportional to the disease severity, 50% (4 of 8 cases), 33% (4 of 12 cases), and no death respectively in severe, moderate, and mild PARDS. PARDS in our context is a serious problem as it is more frequent in children < 5 years, a population considered as fragile, with a high mortality rate especially in indirect lung etiologies of PARDS.

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Section: Introductionmentioning

confidence: 99%

Pediatric acute respiratory distress syndrome in a Moroccan intensive care unit: a retrospective observational study of 23 cases

Benlamkaddem¹,

Bouyerman²,

Berdaï³

et al. 2023

Pan Afr Med J

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Acute lung injury (ALI) is a clinical syndrome characterized by progressive hypoxemia and respiratory distress, caused by diverse endogenous and exogenous factors that injure lung directly or indirectly. ALI is the source of substantial morbidity and mortality in both adult (1,2) and pediatric (3,4) populations and is a major contributor to intensive care unit costs. (5) Sepsis, induced by severe infection of bacteria, virus or fungus, is one of the leading etiologies of ALI.

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confidence: 99%

Seabuckthorn Berries Extract Attenuates Pulmonary Vascular Hyperpermeability in Lipopolysaccharide-Induced Acute Lung Injury in Mice

Liu

Wan

et al. 2021

Chin. J. Integr. Med.

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Objective To investigate the effect of seabuckthorn berries extract (SBE) on pulmonary vascular hyperpermeability in the mice model of acute lung injury (ALI) induced by lipopolysaccharide (LPS). Methods Sixty Kunming mice were allocated into 6 groups by a random number table, including control, LPS, dexamethasone (Dex, 1 mg/kg), and 120, 240 and 480 mg/kg SBE groups, 10 mice in each group. Except the control group, mice were pre-treated with Dex and SBE, respectively, for 7 days before LPS was intraperitoneally injected to induce ALI. Pulmonary vascular hyperpermeability was evaluated by histopathologic observation and transvascular leakage determination. Tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) levels in serum were measured using enzyme-linked immunosorbent assay. The expression of nuclear factor-kappa B (NF-κB) p65 in lung cells was determined by immunofluorescence analysis. The contents of cytoplasmic inhibitor of nuclear factor-κB kinase (IKK) and nuclear p65, as well as downstream proteins of E-selectin (CD62E) and intercellular adhesion molecule-1 (ICAM-1), were determined using Western blot analysis. Results Histopathological observation confirmed SBE treatment alleviated morphological lesion induced by LPS. Compared with the LPS group, 480 mg/kg SBE significantly decreased the water content of lung, Evans blue accumulation in lung tissue, and protein concentration and neutrophils count in bronchoalveolar lavage fluid ( P <0.01); moreover, 480 mg/kg SBE significantly suppressed release of TNF-α and IL-6, and down-regulated expressions of IKK, nuclear p65, ICAM-1 and CD62E ( P <0.01). Conclusion SBE maintained alveolar-capillary barrier integrity under endotoxin challenge in mice by suppressing the key factors in the pathogenesis of ALI. Electronic Supplementary Material Supplementary material (Appendix 1) is available in the online version of this article at 10.1007/s11655-021-3346-1.

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Pediatric Ards: Clinician Recognition Since the Release of the Pediatric Acute Lung Injury Consensus Conference Definition

Cited by 2 publications

References 0 publications

Pediatric acute respiratory distress syndrome in a Moroccan intensive care unit: a retrospective observational study of 23 cases

Pediatric acute respiratory distress syndrome in a Moroccan intensive care unit: a retrospective observational study of 23 cases

Seabuckthorn Berries Extract Attenuates Pulmonary Vascular Hyperpermeability in Lipopolysaccharide-Induced Acute Lung Injury in Mice

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