Journal
PEDIATRIC CRITICAL CARE MEDICINE
Volume 16, Issue 5, Pages 428-439Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PCC.0000000000000350
Keywords
acute lung injury; acute respiratory distress syndrome; consensus development conference; guidelines; pediatrics
Categories
Funding
- Department of Pediatrics, The Pennsylvania State University College of Medicine
- Health Outcome Axis-Ste Justine Research Center, Montreal, Canada
- Respiratory Research Network of Fonds de Recherche du Quebec-Sante, QC, Canada
- Mother and Children French-Speaking Network
- French-Speaking Group in Pediatric Emergency and Intensive Care, French-Speaking Intensive Care Society (SRLF)
- European Society for Pediatric and Neonatal Intensive Care Society
- Australian and New Zealand Intensive Care Society
- Children's Hospital of Richmond of Virginia Commonwealth University
- Division of Critical Care Medicine, CS Mott Children's Hospital at the University of Michigan
- Department of Anesthesia and Critical Care, Children's Hospital of Philadelphia
- respiratory research network of Fonds de Recherche du Quebec-Sante
- Reseau mere enfant de la francophonie
- Research Center of Ste-Justine Hospital
- United States Food and Drug Administration Office of Orphan Product Development
- National Institutes of Health (NIH)
- Seattle Children's Research Institute
- ImmuneXpress
- Philips
- Care Fusion
- Covidien
- Teleflex
- Ikaria
- Respiratory Health Network of the Fonds de la Recherche du Quebec-Sante
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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.
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