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Indian Journal of Pediatrics
Published in: Indian Journal of Pediatrics 11/2010

01-11-2010 | Symposium on PICU Protocols of AIIMS

Management of Acute Lung Injury/ARDS

Authors: Sunil Saharan, Rakesh Lodha, Sushil Kumar Kabra

Published in: Indian Journal of Pediatrics | Issue 11/2010

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Abstract

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are disorders of pulmonary inflammation characterized by hypoxemia and respiratory failure. Children have varying incidence of ALI/ARDS from 2.2 to 16 per 100,000 pediatric population associated with high morbidity, mortality, and financial burden. The diagnostic criteria include: acute onset, severe arterial hypoxemia resistant to oxygen therapy alone (PaO2/FIO2 ratio ≤200 for ARDS and ≤300 for ALI), diffuse pulmonary inflammation (bilateral infiltrates on chest radiograph) and No evidence of left atrial hypertension. Management includes ventilatory therapy including lower tidal volume, relatively high PEEP and supportive care. Guidelines for diagnosis, ventilator management, rescue therapies and supportive care are being discussed in the protocol.
Literature
1.
2.
Bernard GR. Acute respiratory distress syndrome: a historical perspective. Am J Respir Crit Care Med. 2005;172:798–806.CrossRefPubMed
3.
Dahlem P, van Aalderen WM, Bos AP. Pediatric acute lung injury. Paediatr Respir Rev. 2007;8:348–62.CrossRefPubMed
4.
Erickson S, Schibler A, Numa A, et al. Acute lung injury in pediatric intensive care in Australia and New Zealand: a prospective, multicenter, observational study. Pediatr Crit Care Med. 2007;8:317–23.CrossRefPubMed
5.
Randolph AG. Management of acute lung injury and acute respiratory distress syndrome in children. Crit Care Med. 2009;37:2448–54.CrossRefPubMed
6.
Dahlem P, van Aalderen WM, Hamaker ME, Dijkgraaf MG, Bos AP. Incidence and short-term outcome of acute lung injury in mechanically ventilated children. Eur Respir J. 2003;22:980–5.CrossRefPubMed
7.
Rubenfeld GD, Caldwell E, Peabody E, et al. Incidence and outcomes of acute lung injury. N Engl J Med. 2005;353:1685–93.CrossRefPubMed
8.
Kneyber MC, Brouwers AG, Caris JA, Chedamni S, Plotz FB. Acute respiratory distress syndrome: is it underrecognized in the pediatric intensive care unit? Intensive Care Med. 2008;34:751–4.CrossRefPubMed
9.
Lodha R, Kabra SK, Pandey RM. Acute respiratory distress syndrome: experience at a tertiary care hospital. Indian Pediatr. 2001;38:1154–9.PubMed
10.
Bernard GR, Artigas A, Brigham KL, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149:818–24.PubMed
11.
Flori HR, Glidden DV, Rutherford GW, Matthay MA. Pediatric acute lung injury: prospective evaluation of risk factors associated with mortality. Am J Respir Crit Care Med. 2005;171:995–1001.CrossRefPubMed
12.
Hudson LD, Milberg JA, Anardi D, Maunder RJ. Clinical risks for development of the acute respiratory distress syndrome. Am J Respir Crit Care Med. 1995;151:293–301.PubMed
13.
Clements RS, Steel AG, Bates AT, Mackenzie R. Cuffed endotracheal tube use in paediatric prehospital intubation: challenging the doctrine? Emerg Med J. 2007;24:57–8.CrossRefPubMed
14.
The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301–8.CrossRef
15.
Hanson JH, Flori H. Application of the acute respiratory distress syndrome network low-tidal volume strategy to pediatric acute lung injury. Respir Care Clin N Am. 2006;12:349–57.PubMed
16.
Miller MP, Sagy M. Pressure characteristics of mechanical ventilation and incidence of pneumothorax before and after the implementation of protective lung strategies in the management of pediatric patients with severe ARDS. Chest. 2008;134:969–73.CrossRefPubMed
17.
Albuali WH, Singh RN, Fraser DD, et al. Have changes in ventilation practice improved outcome in children with acute lung injury? Pediatr Crit Care Med. 2007;8:324–30.CrossRefPubMed
18.
Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10:1–11.CrossRefPubMed
19.
Shah PS, Ohlsson A, Shah JP. Continuous negative extrathoracic pressure or continuous positive airway pressure for acute hypoxemic respiratory failure in children. Cochrane Database Syst.Rev. 2008;23;(1)(1):CD003699.
20.
Arnold JH, Hanson JH, Toro-Figuero LO, Gutierrez J, Berens RJ, Anglin DL. Prospective, randomized comparison of high-frequency oscillatory ventilation and conventional mechanical ventilation in pediatric respiratory failure. Crit Care Med. 1994;22:1530–9.PubMed
21.
Green TP, Moler FW, Goodman DM. Probability of survival after prolonged extracorporeal membrane oxygenation in pediatric patients with acute respiratory failure. Extracorporeal Life Support Organization. Crit Care Med. 1995;23:1132–9.CrossRefPubMed
22.
Randolph AG, Forbes PW, Gedeit RG, et al. Cumulative fluid intake minus output is not associated with ventilator weaning duration or extubation outcomes in children. Pediatr Crit Care Med. 2005;6:642–7.CrossRefPubMed
23.
Dellinger RP, Levy MM, Carlet JM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008;36:296–327.CrossRefPubMed
24.
Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P. Canadian Critical Care Clinical Practice Guidelines Committee. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr. 2003;27:355–73.CrossRefPubMed
25.
Curley MA, Hibberd PL, Fineman LD, Wypij D, Shih MC, Thompson JE, et al. Effect of prone positioning on clinical outcomes in children with acute lung injury: a randomized controlled trial. JAMA. 2005;294:229–37.CrossRefPubMed
26.
Adhikari NK, Burns KE, Friedrich JO, Granton JT, Cook DJ, Meade MO. Effect of nitric oxide on oxygenation and mortality in acute lung injury: systematic review and meta-analysis. BMJ. 2007;334:779.CrossRefPubMed
27.
Dahlem P, van Aalderen WM, de Neef M, Dijkgraaf MG, Bos AP. Randomized controlled trial of aerosolized prostacyclin therapy in children with acute lung injury. Crit Care Med. 2004;32:1055–60.CrossRefPubMed
28.
Duffett M, Choong K, Ng V, Randolph A, Cook DJ. Surfactant therapy for acute respiratory failure in children: a systematic review and meta-analysis. Crit Care. 2007;11:R66.CrossRefPubMed
29.
Peter JV, John P, Graham PL, Moran JL, George IA, Bersten A. Corticosteroids in the prevention and treatment of acute respiratory distress syndrome (ARDS) in adults: meta-analysis. BMJ. 2008;336:1006–9.CrossRefPubMed
30.
Steinberg KP, Hudson LD, Goodman RB, et al. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med. 2006;354:1671–84.CrossRefPubMed
31.
Meduri GU, Golden E, Freire AX, et al. Methylprednisolone infusion in early severe ARDS: results of a randomized controlled trial. Chest. 2007;131:954–63.CrossRefPubMed
32.
Willson DF, Thomas NJ, Markovitz BP, et al. Effect of exogenous surfactant (calfactant) in pediatric acute lung injury: a randomized controlled trial. JAMA. 2005;293:470–6.CrossRefPubMed
33.
Ben-Abraham R, Weinbroum AA, Roizin H, et al. Long-term assessment of pulmonary function tests in pediatric survivors of acute respiratory distress syndrome. Med Sci Monit. 2002;8:CR153–7.PubMed
Metadata
Title
Management of Acute Lung Injury/ARDS
Authors
Sunil Saharan
Rakesh Lodha
Sushil Kumar Kabra
Publication date
01-11-2010
Publisher
Springer-Verlag
Published in
Indian Journal of Pediatrics / Issue 11/2010
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-010-0169-z

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