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Published on: August 30, 2019

Management of acute lung injury/ARDS

Sunil Saharan1, Rakesh Lodha, Sushil Kumar Kabra

  • 1Division of Pulmonology and Critical Care, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.

Indian Journal of Pediatrics
|September 8, 2010
PubMed

Insights

Pediatric acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) present significant challenges. This protocol outlines current guidelines for diagnosis, management, and supportive care to improve outcomes for children with these critical respiratory conditions.

Area of Science:

  • Pediatric critical care medicine
  • Pulmonology
  • Respiratory medicine

Background:

  • Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are severe inflammatory lung conditions.
  • These syndromes affect the pediatric population, leading to high rates of illness, death, and healthcare costs.
  • Accurate diagnosis and timely management are crucial for improving patient outcomes.

Purpose of the Study:

  • To present a protocol for the diagnosis and management of ALI and ARDS in children.
  • To discuss current guidelines for ventilatory therapy, rescue treatments, and supportive care.
  • To provide a comprehensive resource for clinicians managing pediatric ALI/ARDS.

Main Methods:

  • The protocol defines diagnostic criteria for ALI/ARDS, including acute onset, hypoxemia (PaO₂/FIO₂ ratio thresholds), bilateral infiltrates on chest imaging, and absence of left atrial hypertension.
  • Management strategies emphasize ventilatory support with lower tidal volumes and appropriate positive end-expiratory pressure (PEEP).
  • The protocol also addresses rescue therapies and essential supportive care measures.

Main Results:

  • The protocol establishes clear diagnostic criteria for ALI and ARDS in pediatric patients.
  • It recommends specific ventilatory strategies, including lung-protective ventilation.
  • Guidelines for advanced therapies and supportive care are detailed to manage these complex conditions.

Conclusions:

  • This protocol provides a standardized approach to the diagnosis and management of pediatric ALI/ARDS.
  • Adherence to these guidelines can potentially reduce morbidity and mortality associated with these conditions.
  • The protocol serves as a valuable reference for healthcare professionals involved in the care of critically ill children with respiratory failure.

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