Pediatric Acute Respiratory Distress Syndrome: Consensus Recommendations From the Pediatric Acute Lung Injury Consensus Conference

Philippe Jouvet, Neal J. Thomas*, Douglas F. Willson, Simon Erickson, Robinder Khemani, Lincoln Smith, Jerry Zimmerman, Mary Dahmer, Heidi Flori, Michael Quasney, Anil Sapru, Ira M. Cheifetz, Peter C. Rimensberger, Martin Kneyber, Robert F. Tamburro, Martha A. Q. Curley, Vinay Nadkarni, Stacey Valentine, Guillaume Emeriaud, Christopher NewthChristopher L. Carroll, Sandrine Essouri, Heidi Dalton, Duncan Macrae, Yolanda Lopez-Cruces, Michael Quasney, Miriam Santschi, R. Scott Watson, Melania Bembea, Pediat Acute Lung Injury Consensus

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

353 Citations (Scopus)

Abstract

Objective: To describe the final recommendations of the Pediatric Acute Lung Injury Consensus Conference.

Design: Consensus conference of experts in pediatric acute lung injury.

Setting: Not applicable.

Subjects: PICU patients with evidence of acute lung injury or acute respiratory distress syndrome.

Interventions: None.

Methods: A panel of 27 experts met over the course of 2 years to develop a taxonomy to define pediatric acute respiratory distress syndrome and to make recommendations regarding treatment and research priorities. When published, data were lacking a modified Delphi approach emphasizing strong professional agreement was used.

Measurements and Main Results: A panel of 27 experts met over the course of 2 years to develop a taxonomy to define pediatric acute respiratory distress syndrome and to make recommendations regarding treatment and research priorities. When published data were lacking a modified Delphi approach emphasizing strong professional agreement was used. The Pediatric Acute Lung Injury Consensus Conference experts developed and voted on a total of 151 recommendations addressing the following topics related to pediatric acute respiratory distress syndrome: 1) Definition, prevalence, and epidemiology; 2) Pathophysiology, comorbidities, and severity; 3) Ventilatory support; 4) Pulmonary-specific ancillary treatment; 5) Nonpulmonary treatment; 6) Monitoring; 7) Noninvasive support and ventilation; 8) Extracorporeal support; and 9) Morbidity and long-term outcomes. There were 132 recommendations with strong agreement and 19 recommendations with weak agreement. Once restated, the final iteration of the recommendations had none with equipoise or disagreement.

Conclusions: The Consensus Conference developed pediatric-specific definitions for acute respiratory distress syndrome and recommendations regarding treatment and future research priorities. These are intended to promote optimization and consistency of care for children with pediatric acute respiratory distress syndrome and identify areas of uncertainty requiring further investigation.

Original languageEnglish
Pages (from-to)428-439
Number of pages12
JournalPediatric critical care medicine
Volume16
Issue number5
DOIs
Publication statusPublished - Jun-2015

Keywords

  • acute lung injury
  • acute respiratory distress syndrome
  • consensus development conference
  • guidelines
  • pediatrics
  • CLINICAL-TRIAL
  • CHILDREN
  • DEFINITIONS
  • SEVERITY
  • DISEASE
  • ADULTS
  • ARDS

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