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Updated: Jun 7, 2026

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 respiratory distress syndrome

Priya Prabhakaran1

  • 1Division of Pediatric Critical Care, University of Alabama, Birmingham, AL 35233, USA. pprabhakaran@peds.uab.edu

Indian Pediatrics
|November 5, 2010
PubMed

Insights

Low tidal volume ventilation is the only proven strategy to improve outcomes in pediatric acute respiratory distress syndrome (ARDS). This approach helps minimize ventilator-induced lung injury and associated multi-organ failure in critically ill children.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Physiology
  • Mechanical Ventilation

Background:

  • Acute respiratory distress syndrome (ARDS) is a frequent and severe condition in pediatric intensive care units.
  • ARDS presents heterogeneity in causes and significant mortality risk.
  • Numerous supportive therapies are available for managing pediatric ARDS.

Purpose of the Study:

  • To review current evidence on supportive therapies for pediatric acute respiratory distress syndrome (ARDS).
  • To identify strategies that improve outcomes in children with ARDS.
  • To evaluate the efficacy of various interventions based on recent pediatric randomized controlled trials.

Main Methods:

  • Literature search conducted on PubMed using keywords 'ARDS' and related terms.
  • Inclusion of pediatric randomized controlled trials published within the last 10 years.
  • Emphasis on pediatric literature, supplemented by key adult studies; evidence levels I and II prioritized.

Main Results:

  • Low tidal volume ventilation (≤ 6 mL/kg predicted body weight) is the sole strategy consistently improving ARDS outcomes.
  • Judicious use of positive end-expiratory pressure is recommended for lung recruitment.
  • Insufficient evidence exists for routine use of high-frequency ventilation, prone positioning, or inhaled nitric oxide.
  • Calfactant therapy shows promise for direct lung injury ARDS; routine corticosteroids are not supported.

Conclusions:

  • Low tidal volume ventilation is crucial for improving outcomes and minimizing lung injury in pediatric ARDS.
  • Careful application of positive end-expiratory pressure is essential.
  • Further research is needed to establish the role of emerging therapies like calfactant.
Abstract

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