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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury
Insights
The Pediatric Acute Lung Injury Consensus Conference established new definitions and treatment recommendations for pediatric acute respiratory distress syndrome (PARDS). These guidelines aim to standardize care and guide future research for critically ill children.
Area of Science:
- Pediatric Critical Care Medicine
- Respiratory Medicine
- Clinical Consensus
Background:
- Pediatric acute respiratory distress syndrome (PARDS) lacks standardized definitions and treatment protocols.
- Previous guidelines were often extrapolated from adult data, limiting their applicability to children.
Objective:
To describe the final recommendations of the Pediatric Acute Lung Injury Consensus Conference.
Design:
Consensus conference of experts in pediatric acute lung injury.
Setting:
Not applicable.
Subjects:
PICU patients with evidence of acute lung injury or acute respiratory distress syndrome.
Interventions:
None.
Methods:
A panel of 27 experts met over the course of 2 years to develop a taxonomy to define pediatric acute respiratory distress syndrome and to make recommendations regarding treatment and research priorities. When published, data were lacking a modified Delphi approach emphasizing strong professional agreement was used.
Measurements And Main Results:
A panel of 27 experts met over the course of 2 years to develop a taxonomy to define pediatric acute respiratory distress syndrome and to make recommendations regarding treatment and research priorities. When published data were lacking a modified Delphi approach emphasizing strong professional agreement was used. The Pediatric Acute Lung Injury Consensus Conference experts developed and voted on a total of 151 recommendations addressing the following topics related to pediatric acute respiratory distress syndrome: 1) Definition, prevalence, and epidemiology; 2) Pathophysiology, comorbidities, and severity; 3) Ventilatory support; 4) Pulmonary-specific ancillary treatment; 5) Nonpulmonary treatment; 6) Monitoring; 7) Noninvasive support and ventilation; 8) Extracorporeal support; and 9) Morbidity and long-term outcomes. There were 132 recommendations with strong agreement and 19 recommendations with weak agreement. Once restated, the final iteration of the recommendations had none with equipoise or disagreement.
Conclusions:
The Consensus Conference developed pediatric-specific definitions for acute respiratory distress syndrome and recommendations regarding treatment and future research priorities. These are intended to promote optimization and consistency of care for children with pediatric acute respiratory distress syndrome and identify areas of uncertainty requiring further investigation.
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