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Methodology of the Second Pediatric Acute Lung Injury Consensus Conference
Narayan Iyer1, Robinder Khemani2, Guillaume Emeriaud3
1Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Insights
The Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) developed evidence-based recommendations for diagnosing and managing pediatric acute respiratory distress syndrome (PARDS). Experts identified research priorities to address knowledge gaps in PARDS care.
Area of Science:
- Pediatric Critical Care Medicine
- Pulmonology
- Respiratory Therapy
Background:
- Pediatric Acute Respiratory Distress Syndrome (PARDS) presents complex diagnostic and management challenges.
- Existing guidelines require updates based on the latest scientific evidence and clinical consensus.
- The Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) was convened to address these needs.
Purpose of the Study:
- To develop evidence-based clinical recommendations for the diagnosis and management of PARDS.
- To establish expert-based consensus statements where evidence is lacking.
- To identify critical research priorities for advancing PARDS care.
Main Methods:
- Conducted systematic and scoping reviews of literature from 2012 to 2022.
- Utilized the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for evidence appraisal.
- Convened a multidisciplinary panel of 52 international experts in pediatric critical care and related fields.
- Employed a methodology modeled after PALICC 2015, including web-based meetings and rigorous review processes.
Main Results:
- Developed comprehensive recommendations and consensus statements covering 11 key areas of PARDS.
- Formulated evidence tables and graded recommendations using the GRADE system.
- Identified specific knowledge gaps and outlined future research directions for PARDS.
Conclusions:
- The PALICC-2 conference successfully generated updated, evidence-based guidelines for PARDS diagnosis and management.
- Consensus statements provide crucial guidance in areas with limited empirical evidence.
- The identified research priorities will guide future investigations to improve outcomes for children with PARDS.
Objectives:
This article describes the methodology used for The Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2). The PALLIC-2 sought to develop evidence-based clinical recommendations and when evidence was lacking, expert-based consensus statements and research priorities for the diagnosis and management of pediatric acute respiratory distress syndrome (PARDS).
Data Sources:
Electronic searches were conducted using PubMed, Embase, and Cochrane Library (CENTRAL) databases from 2012 to March 2022.
Study Selection:
Content was divided into 11 sections related to PARDS, with abstract and full text screening followed by data extraction for studies which met inclusion with no exclusion criteria.
Data Extraction:
We used a standardized data extraction form to construct evidence tables, grade the evidence, and formulate recommendations or statements using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
Data Synthesis:
This consensus conference was comprised of a multidisciplinary group of international experts in pediatric critical care, pulmonology, respiratory care, and implementation science which followed standards set by the Institute of Medicine, using the GRADE system and Research And Development/University of California, Los Angeles appropriateness method, modeled after PALICC 2015. The panel of 52 content and four methodology experts had several web-based meetings over the course of 2 years. We conducted seven systematic reviews and four scoping reviews to cover the 11 topic areas. Dissemination was via primary publication listing all statements and separate supplemental publications for each subtopic that include supporting arguments for each recommendation and statement.
Conclusions:
A consensus conference of experts from around the world developed recommendations and consensus statements for the definition and management of PARDS and identified evidence gaps which need further research.
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