Nonpulmonary Treatments for Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference.

Stacey L Valentine, Sapna R Kudchadkar, Shan Ward, Brenda M Morrow, Vinay M Nadkarni, Martha A Q Curley

Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies 2023;24(12 Suppl 2):S45-S60

PMID: 36661435

Full Text on Ovid Technologies, Inc. View on PubMed

Abstract

OBJECTIVES

To provide an updated review of the literature on nonpulmonary treatments for pediatric acute respiratory distress syndrome (PARDS) from the Second Pediatric Acute Lung Injury Consensus Conference.

DATA SOURCES

MEDLINE (Ovid), Embase (Elsevier), and CINAHL Complete (EBSCOhost).

STUDY SELECTION

Searches were limited to children with PARDS or hypoxic respiratory failure focused on nonpulmonary adjunctive therapies (sedation, delirium management, neuromuscular blockade, nutrition, fluid management, transfusion, sleep management, and rehabilitation).

DATA EXTRACTION

Title/abstract review, full-text review, and data extraction using a standardized data collection form.

DATA SYNTHESIS

The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize evidence and develop recommendations. Twenty-five studies were identified for full-text extraction. Five clinical practice recommendations were generated, related to neuromuscular blockade, nutrition, fluid management, and transfusion. Thirteen good practice statements were generated on the use of sedation, iatrogenic withdrawal syndrome, delirium, sleep management, rehabilitation, and additional information on neuromuscular blockade and nutrition. Three research statements were generated to promote further investigation in nonpulmonary therapies for PARDS.

CONCLUSIONS

These recommendations and statements about nonpulmonary treatments in PARDS are intended to promote optimization and consistency of care for patients with PARDS and identify areas of uncertainty requiring further investigation.

Address: Department of Pediatrics, Division of Pediatric Critical Care, University of Massachusetts Children´s Medical Center, Worcester, MA.; Departments of Anesthesiology and Critical Care Medicine, Pediatrics, and Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Pediatrics, Division of Critical Care, University of California San Francisco, Benioff Children's Hospital San Francisco and Oakland, San Francisco, CA.; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.; Department of Anesthesia and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

DOI: 10.1097/PCC.0000000000003158

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MeSH Terms: Child, Humans, Respiratory Distress Syndrome, Respiration, Artificial, Neuromuscular Blockade, Acute Lung Injury, Delirium