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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)S45-S60
JournalPediatric Critical Care Medicine
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2023

Keywords

  • and rehabilitation
  • children
  • critical illness
  • delirium management
  • fluid management
  • neuromuscular blockade
  • nutrition
  • pediatric acute respiratory distress syndrome
  • sedation
  • sleep management
  • transfusion

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Pediatrics, Perinatology, and Child Health

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