title: Adjunctive treatments in pediatric acute respiratory distress syndrome.
abstract: Acute respiratory distress syndrome (ARDS) is a devastating process that involves pulmonary inflammation, alveolar damage and hypoxemic respiratory failure. Although advances in management approaches over the past two decades have resulted in significantly improved outcomes, death from pediatric ARDS may still occur in up to 35% of patients. While invasive mechanical ventilation is an essential component of ARDS management, various adjuncts have been utilized as treatment for these patients. However, evidence-based data in infants and children in this area are lacking. In this article, the authors review the available evidence supporting (or not supporting) the use of non-ventilatory adjunctive strategies in the management of pediatric ARDS, including prone positioning, pulmonary vasodilators, β-agonists, steroids and surfactant.
authors.affiliation: Children's Intensive Care Unit, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore.
authors.forename: Yee Hui
authors.initials: YH
authors.lastname: Mok
authors.forename: Jan Hau
authors.initials: JH
authors.lastname: Lee
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Rehder
authors.forename: David A
authors.initials: DA
authors.lastname: Turner
mesh_terms: D002648:Child; D006801:Humans; D016684:Prone Position; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000628:therapy*
chemical_list: D011663:Pulmonary Surfactants
keywords: acute respiratory distress syndrome; children; nitric oxide; pediatric; prone positioning; prostaglandin; pulmonary hypertension; steroid; surfactant