Paediatric ventilation treatment of acute lung injury in Nordic intensive care units

Area of Science:

• Pediatric Intensive Care Medicine
• Respiratory Medicine
• Critical Care

Background:

• Pediatric acute respiratory distress syndrome (ARDS) treatment relies heavily on adult data and varies significantly across institutions.
• Current pediatric ARDS management lacks standardized protocols, necessitating research into regional practices.

Purpose of the Study:

• To investigate and compare ventilation strategies for pediatric ARDS in Nordic countries with international practices.
• To identify variations and commonalities in treatment approaches for children with ARDS.

Main Methods:

• A questionnaire survey was distributed to 21 major Nordic intensive care units treating pediatric ARDS patients (ages 1 month to 6 years).
• The survey focused on ventilation strategies, medication use, and advanced respiratory support availability.
• Exclusions included preterm infants and children with congenital conditions.

Main Results:

• 86% of surveyed units responded, with 50% being dedicated pediatric intensive care units.
• Written guidelines for ARDS management were present in 44% of units.
• Pressure control ventilation was dominant (89%), with frequent use of cuffed endotracheal tubes (50%). Bronchodilators were universal; steroids (83%) and surfactant (39%) usage was notable. Advanced therapies like inhaled nitric oxide, high-frequency oscillation, neurally adjusted ventilator assist, and extracorporeal membrane oxygenation were widely available.

Conclusions:

• Ventilation strategies for pediatric ARDS in the Nordic region demonstrate considerable uniformity and align with international standards.
• The utilization of steroids and surfactant in pediatric ARDS management appears more prevalent in Nordic countries compared to findings in other international studies.