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Biomarkers for Pediatric Acute Respiratory Distress Syndrome: A Systematic Review

Fuxiang Yang1, Jiahuan Zou2, Ling Zheng3

  • 1Department of Neonatology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, 563000, People's Republic of China.

Journal of Inflammation Research
|July 6, 2026
PubMed

Insights

Nine biomarkers show potential for diagnosing pediatric acute respiratory distress syndrome (PARDS) in critically ill children. Further research is needed to validate these biomarkers for consistent clinical use.

Area of Science:

  • Critical Care Medicine
  • Pediatric Pulmonology
  • Biomarker Discovery

Background:

  • Pediatric acute respiratory distress syndrome (PARDS) is a severe condition in critically ill children with significant short- and long-term consequences.
  • Current diagnostic criteria (Berlin definition) present challenges in pediatric populations, hindering early detection and clinical application.
  • Existing evidence on biomarkers for PARDS diagnosis, prediction, and prognosis is fragmented, necessitating a systematic review.

Purpose of the Study:

  • To systematically synthesize evidence on biomarkers for the diagnosis, prediction, and prognosis of PARDS in critically ill children.
  • To identify and categorize potential biomarkers based on their underlying mechanisms.
  • To evaluate the diagnostic and predictive capabilities of identified biomarkers.

Main Methods:

  • A comprehensive systematic literature search was conducted across multiple databases up to September 12, 2025.
  • Study quality was assessed using the Revised Newcastle-Ottawa Scale and QUADAS-2.
  • Data extraction focused on study characteristics, biomarker details, PARDS criteria, and outcome measures.

Main Results:

  • Nine studies involving 759 children met the inclusion criteria, identifying nine biomarkers across epithelial, stress response, inflammatory, and endothelial injury pathways.
  • Six biomarkers exhibited strong predictive and diagnostic capabilities (AUC > 0.80), while three showed moderate efficacy (AUC 0.60-0.80).
  • Identified biomarkers include CC16, Glypican-4, nucleosomes, Gal-3BP, miR-424, mirR-21, HBP, PGRN, and VWF.

Conclusions:

  • The nine identified biomarkers show promise for PARDS assessment in pediatric critical care.
  • Inconsistent clinical utility highlights the need for further validation.
  • Future large-scale, multicenter prospective studies and technological advancements are crucial for optimizing biomarker use in PARDS management.
Abstract

Keywords:
PARDSbiomarkersdiagnosispredictionprognosissystematic review

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