Acute respiratory distress syndrome in the pediatric patient

Pediatric acute respiratory distress syndrome (PARDS) is the clinical expression of severe non-cardiogenic pulmonary edema. The agreed-upon definition shares common criteria with those for adults, but also includes differences determined by the particular characteristics inherent to pediatric patients. The definition of PARDS does not require bilateral infiltrates on the chest X-ray; hypoxemia can be identified non-invasively using the blood oxygen saturation/fraction of inspired oxygen (S/F) ratio; it is stratified into two groups (mild-moderate and severe) after a stabilization period of at least 4 h; and the oxygenation index and the oxygenation-saturation ratio are used in intubated patients. Optimized respiratory support settings should prevent lung injury and allow for early identification of patients requiring extracorporeal membrane oxygenation (ECMO). This article seeks to conduct a critical analysis of PARS. A precise diagnosis of this syndrome remains challenging.