Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2).
Por:
Emeriaud G, López-Fernández YM, Iyer NP, Bembea MM, Agulnik A, Barbaro RP, Baudin F, Bhalla A, Brunow de Carvalho W, Carroll CL, Cheifetz IM, Chisti MJ, Cruces P, Curley MAQ, Dahmer MK, Dalton HJ, Erickson SJ, Essouri S, Fernández A, Flori HR, Grunwell JR, Jouvet P, Killien EY, Kneyber MCJ, Kudchadkar SR, Korang SK, Lee JH, Macrae DJ, Maddux A, Modesto I Alapont V, Morrow BM, Nadkarni VM, Napolitano N, Newth CJL, Pons-Odena M, Quasney MW, Rajapreyar P, Rambaud J, Randolph AG, Rimensberger P, Rowan CM, Sanchez-Pinto LN, Sapru A, Sauthier M, Shein SL, Smith LS, Steffen K, Takeuchi M, Thomas NJ, Tse SM, Valentine S, Ward S, Watson RS, Yehya N, Zimmerman JJ and Khemani RG
Publicada:
1 feb 2023
Ahead of Print:
20 ene 2023
Resumen:
OBJECTIVES: We sought to update our 2015 work in the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) guidelines for the diagnosis and management of pediatric acute respiratory distress syndrome (PARDS), considering new evidence and topic areas that were not previously addressed. DESIGN: International consensus conference series involving 52 multidisciplinary international content experts in PARDS and four methodology experts from 15 countries, using consensus conference methodology, and implementation science. SETTING: Not applicable. PATIENTS: Patients with or at risk for PARDS. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eleven subgroups conducted systematic or scoping reviews addressing 11 topic areas: 1) definition, incidence, and epidemiology; 2) pathobiology, severity, and risk stratification; 3) ventilatory support; 4) pulmonary-specific ancillary treatment; 5) nonpulmonary treatment; 6) monitoring; 7) noninvasive respiratory support; 8) extracorporeal support; 9) morbidity and long-term outcomes; 10) clinical informatics and data science; and 11) resource-limited settings. The search included MEDLINE, EMBASE, and CINAHL Complete (EBSCOhost) and was updated in March 2022. Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to summarize evidence and develop the recommendations, which were discussed and voted on by all PALICC-2 experts. There were 146 recommendations and statements, including: 34 recommendations for clinical practice; 112 consensus-based statements with 18 on PARDS definition, 55 on good practice, seven on policy, and 32 on research. All recommendations and statements had agreement greater than 80%. CONCLUSIONS: PALICC-2 recommendations and consensus-based statements should facilitate the implementation and adherence to the best clinical practice in patients with PARDS. These results will also inform the development of future programs of research that are crucially needed to provide stronger evidence to guide the pediatric critical care teams managing these patients.
Filiaciones:
Emeriaud G:
Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
López-Fernández YM:
Pediatric Intensive Care Unit, Department of Pediatrics, Cruces University Hospital, Biocruces-Bizkaia Health Research Institute, Bizkaia, Spain
Iyer NP:
Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
Bembea MM:
Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
Agulnik A:
Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN
Barbaro RP:
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
Baudin F:
Pediatric Intensive Care Unit, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Réanimation Pédiatrique, Lyon, France
Bhalla A:
Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles. Keck School of Medicine, University of Southern California, Los Angeles, CA
Brunow de Carvalho W:
Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Carroll CL:
Department of Pediatrics, Connecticut Children´s, Hartford, CT
Cheifetz IM:
Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH
Chisti MJ:
Dhaka Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh
Cruces P:
Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile
Departamento de Pediatría, Unidad de Paciente Crítico Pediátrico, Facultad de Ciencias de la Vida, Hospital El Carmen de Maipú, Santiago, Chile
Curley MAQ:
Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA
Research Institute, Children's Hospital of Philadelphia, Philadelphia, PA
Dahmer MK:
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
Dalton HJ:
Department of Pediatrics and Heart and Vascular Institute, INOVA Fairfax Medical Center, Falls Church, VA
Erickson SJ:
Department of Paediatric Critical Care, Perth Children's Hospital Western Australia, Perth, WA, Australia
Essouri S:
Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
Fernández A:
Pediatric Intensive Care Unit, Emergency Department, Hospital General de Agudos "C. Durand" Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
Flori HR:
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
Grunwell JR:
Division of Critical Care, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
Jouvet P:
Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
Killien EY:
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
Kneyber MCJ:
Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Kudchadkar SR:
Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
Departments of Pediatrics, Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD
Korang SK:
Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles. Keck School of Medicine, University of Southern California, Los Angeles, CA
Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region of Denmark, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Lee JH:
KK Women's and Children's Hospital, Singapore and Duke-NUS Medical School, Singapore
Macrae DJ:
Cardiac Critical Care and ECMO, Sidra Medicine, Doha, Qatar
Maddux A:
Department of Pediatrics, Section of Pediatric Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
Modesto I Alapont V:
Pediatric Intensive Care Unit, Hospital Universitari I Politècnic La Fe, València, Spain
Morrow BM:
Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
Nadkarni VM:
Department of Anesthesiology, Critical Care and Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
Napolitano N:
Respiratory Therapy Department, Children's Hospital of Philadelphia, Philadelphia, PA
Newth CJL:
Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles. Keck School of Medicine, University of Southern California, Los Angeles, CA
Pons-Odena M:
Immunological and Respiratory Disorders, Paediatric Critical Care Unit Research Group, Institut de Recerca Sant Joan de Déu, Pediatric Intensive Care and Intermediate Care Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Quasney MW:
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
Rajapreyar P:
Department of Pediatrics, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, WI
Rambaud J:
Departement of Pediatric and Neonatal Intensive Care, Armand-Trousseau Hospital, Sorbonne University, Paris, France
Randolph AG:
Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, and Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, MA
Rimensberger P:
Division of Neonatology and Paediatric Intensive Care, University of Geneva, Geneva, Switzerland
Rowan CM:
Department of Pediatrics, Division of Pediatric Critical Care Medicine, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN
Sanchez-Pinto LN:
Departments of Pediatrics (Critical Care) and Preventive Medicine (Health & Biomedical Informatics), Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
Sapru A:
Division of Pediatric Critical Care, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA
Sauthier M:
Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
Shein SL:
Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH
Smith LS:
Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA
Steffen K:
Department of Pediatrics, Division of Pediatric Critical Care, Stanford University, Palo Alto, CA
Takeuchi M:
Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, Osaka, Japan
Thomas NJ:
Division of Pediatric Critical Care Medicine, Department of Pediatrics and Public Health Sciences, Penn State University College of Medicine, Hershey, PA
Tse SM:
Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
Valentine S:
Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA
Ward S:
Department of Pediatrics, University of California San Francisco, Benioff Children's Hospitals, San Francisco and Oakland, CA
Watson RS:
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
Center for Child Health, Behavior, and Development, Seattle Children's Research Institute Seattle, WA
Yehya N:
Department of Anesthesiology, Critical Care and Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
Zimmerman JJ:
Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA
Harborview Medical Center, University of Washington School of Medicine, Seattle, WA
Khemani RG:
Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles. Keck School of Medicine, University of Southern California, Los Angeles, CA
Green Published, hybrid
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