Pulmonary specific ancillary treatment for pediatric acute respiratory distress syndrome: Proceedings from the pediatric acute lung injury consensus conference

for the Pediatric Acute Lung Injury Consensus Conference Group

Research output: Contribution to journalArticle

Abstract

Objective: To provide an overview of the current literature on pulmonary-specific therapeutic approaches to pediatric acute respiratory distress syndrome to determine recommendations for clinical practice and/or future research. Data Sources: PubMed, EMBASE, CINAHL, SCOPUS, and the Cochrane Library were searched from inception until January 2013 using the following keywords in various combinations: ARDS, treatment, nitric oxide, heliox, steroids, surfactant, etanercept, prostaglandin therapy, inhaled beta adrenergic receptor agonists, N-acetylcysteine, ipratroprium bromide, dornase, plasminogen activators, fibrinolytics or other anticoagulants, and children. No language restrictions were applied. References from identified articles were searched for additional publications. Study Selection: All clinical studies pertaining to pulmonary-specific therapeutic approaches to pediatric acute respiratory distress syndrome were reviewed. If clinical pediatric data were sparse or unavailable, the findings from studies of adult acute respiratory distress syndrome and animal models that might be relevant to pediatric acute respiratory distress syndrome were examined. Data Extraction: All relevant studies were reviewed and pertinent data abstracted. Data Synthesis: Over the course of three international meetings, the pertinent findings of the literature review were discussed by a panel of 24 experts in the field representing 21 academic institutions and 8 countries. Recommendations developed and the supporting literature were distributed to all panel members without a conflict of interest and were scored by using the Research ANd Development/University of California, Los Angeles Appropriateness method. The modified Delphi approach was used as the methodology to achieve consensus among the panel. Conclusions: Overall, the routine use of surfactant, inhaled nitric oxide, glucocorticoids, prone positioning, endotracheal suctioning, and chest physiotherapy cannot be recommended. Inhaled nitric oxide should only be used for patients with documented pulmonary hypertension and/or right ventricular failure. Prone positioning may be considered in patients with severe pediatric acute respiratory distress syndrome. Future studies are definitely warranted to establish the role, if any, of these ancillary treatment modalities in pediatric acute respiratory distress syndrome.

Original languageEnglish (US)
Pages (from-to)S61-S72
JournalPediatric Critical Care Medicine
Volume16
Issue number5
DOIs
StatePublished - Jun 1 2015

Fingerprint

Acute Lung Injury
Adult Respiratory Distress Syndrome
Consensus
Pediatrics
Lung
Nitric Oxide
Surface-Active Agents
Therapeutics
Conflict of Interest
Adrenergic beta-Agonists
Los Angeles
Plasminogen Activators
Information Storage and Retrieval
Acetylcysteine
Bromides
Pulmonary Hypertension
PubMed
Anticoagulants
Glucocorticoids
Libraries

Keywords

  • Acute lung injury
  • Acute respiratory distress syndrome
  • Pulmonary therapies

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Pulmonary specific ancillary treatment for pediatric acute respiratory distress syndrome : Proceedings from the pediatric acute lung injury consensus conference. / for the Pediatric Acute Lung Injury Consensus Conference Group.

In: Pediatric Critical Care Medicine, Vol. 16, No. 5, 01.06.2015, p. S61-S72.

Research output: Contribution to journalArticle

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keywords = "Acute lung injury, Acute respiratory distress syndrome, Pulmonary therapies",
author = "{for the Pediatric Acute Lung Injury Consensus Conference Group} and Tamburro, {Robert F.} and Kneyber, {Martin C J} and Philippe Jouvet and Thomas, {Neal J.} and Willson, {Douglas F.} and Simon Erickson and Robinder Khemani and Lincoln Smith and Jerry Zimmerman and Mary Dahmer and Heidi Flori and Michael Quasney and Anil Sapru and Cheifetz, {Ira M.} and Rimensberger, {Peter C.} and Curley, {Martha A Q} and Vinay Nadkarni and Stacey Valentine and Guillaume Emeriaud and Christopher Newth and Carroll, {Christopher L.} and Sandrine Essouri and Heidi Dalton and Duncan Macrae and Yolanda Lopez and Miriam Santschi and Watson, {R. Scott} and Melania Bembea",
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