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Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)
06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)

Published on: April 7, 2021

Acute lung injury and acute respiratory distress syndrome

Anil Vasudevan1, Rakesh Lodha, S K Kabra

  • 1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

Indian Journal of Pediatrics
|September 4, 2004
PubMed

Insights

Acute lung injury and acute respiratory distress syndrome (ALI/ARDS) affect children in pediatric intensive care units, presenting significant challenges. Advances in supportive care have reduced mortality rates for these critical lung conditions.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pulmonology
  • Intensive Care Medicine

Background:

  • Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are critical conditions in pediatric intensive care units (PICUs).
  • These syndromes involve severe lung inflammation and edema, affecting alveolar barriers.
  • Incidence rates in children range from 8.5 to 16 per 1000 PICU admissions.

Purpose of the Study:

  • To review the characteristics, treatment, and outcomes of ALI/ARDS in pediatric populations.
  • To highlight current management strategies and their impact on patient outcomes.
  • To discuss emerging therapeutic approaches for non-resolving cases.

Main Methods:

  • Review of pathological phases of ARDS: inflammatory, proliferative, and fibrotic.
  • Discussion of ventilatory strategies including optimal PEEP, low tidal volume, and FiO2.
  • Evaluation of adjunctive therapies like prone positioning and potential roles for corticosteroids.

Main Results:

  • Supportive care and control of the initiating cause are the cornerstones of ARDS treatment.
  • Ventilator management aims to balance gas exchange with minimizing ventilator-induced lung injury.
  • Prone positioning improves oxygenation; high-frequency ventilation's impact on outcomes is debated.
  • Pharmacological interventions have shown limited impact, though corticosteroids show promise in specific cases.

Conclusions:

  • Mortality rates for pediatric ALI/ARDS have decreased due to improved critical care support.
  • Optimized supportive care, particularly mechanical ventilation strategies, is crucial.
  • Further research into pharmacological treatments, including corticosteroids, may benefit non-resolving ARDS.

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