title: The outcomes of children with pediatric acute respiratory distress syndrome: proceedings from the Pediatric Acute Lung Injury Consensus Conference.
abstract: OBJECTIVE
  To provide additional details and evidence behind the recommendations for outcomes assessment of patients with pediatric acute respiratory distress syndrome from the Pediatric Acute Lung Injury Consensus Conference.
  
  
  METHODS
  Consensus conference of experts in pediatric acute lung injury.
  
  
  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. The outcomes subgroup comprised four experts. When published data were lacking, a modified Delphi approach emphasizing strong professional agreement was used.
  
  
  RESULTS
  The Pediatric Acute Lung Injury Consensus Conference experts developed and voted on a total of 151 recommendations addressing the topics related to pediatric acute respiratory distress syndrome, seven of which related to outcomes after pediatric acute respiratory distress syndrome. All seven recommendations had strong agreement. Children with acute respiratory distress syndrome continue to have a high mortality, specifically, in relation to certain comorbidities and etiologies related to pediatric acute respiratory distress syndrome. Comorbid conditions, such as an immunocompromised state, increase the risk of mortality even further. Likewise, certain etiologies, such as non-pulmonary sepsis, also place children at a higher risk of mortality. Significant long-term effects were reported in adult survivors of acute respiratory distress syndrome: diminished lung function and exercise tolerance, reduced quality of life, and diminished neurocognitive function. Little knowledge of long-term outcomes exists in children who survive pediatric acute respiratory distress syndrome. Characterization of the longer term consequences of pediatric acute respiratory distress syndrome in children is vital to help identify opportunities for improved therapeutic and rehabilitative strategies that will lessen the long-term burden of pediatric acute respiratory distress syndrome and improve the quality of life in children.
  
  
  CONCLUSIONS
  The Consensus Conference developed pediatric-specific recommendations for pediatric acute respiratory distress syndrome regarding outcome measures and future research priorities. These recommendations 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.
authors.affiliation: 1Division of Pediatric Critical Care Medicine, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI. 2Division of Pediatric Critical Care Medicine, Department of Pediatrics, Cruces University Hospital, Bizkaia, Spain. 3Division of Pediatric Critical Care, Department of Pediatrics, Universite de Sherbrooke, Sherbrooke, QC, Canada. 4Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington and Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Quasney
authors.forename: Yolanda M
authors.initials: YM
authors.lastname: López-Fernández
authors.forename: Miriam
authors.initials: M
authors.lastname: Santschi
authors.forename: R Scott
authors.initials: RS
authors.lastname: Watson
mesh_terms: D000208:Acute Disease; D001519:Behavior; D015415:Biomarkers; D003071:Cognition; D015897:Comorbidity; D005190:Family; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008603:Mental Health; D009422:Nervous System Diseases / Q000209:etiology; D011379:Prognosis; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D012129:Respiratory Function Tests; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers