Acute lung injury and acute respiratory distress syndrome

Indian Journal of Pediatrics
Anil VasudevanS K Kabra

Abstract

Acute lung injury and acute respiratory distress syndrome are an important challenge for pediatric intensive care units. These disorders are characterized by a significant inflammatory response to a local (pulmonary) or remote (systemic) insult resulting in injury to alveolar epithelial and endothelial barriers of the lung, acute inflammation and protein rich pulmonary edema. The reported rates in children vary from 8.5 to 16 cases / 1000 pediatric intensive care unit (PICU) admissions. The pathological features of ARDS are described as passing through three overlapping phases - an inflammatory or exudative phase (0-7 days), a proliferative phase (7-21 days) and lastly a fibrotic phase (from day 10). The treatment of ARDS rests on good supportive care and control of initiating cause. The goal of ventilating patients with ALI/ARDS should be to maintain adequate gas exchange with minimal ventilator induced lung injury. This can be achieved by use of optimum PEEP, low tidal volume and appropriate FiO2. High frequency ventilation can improve oxygenation but does affect the outcomes. Prone positioning is a useful strategy to improve oxygenation. Pharmacological strategies have not made any significant impact on the outcomes. Prelimi...Continue Reading

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Citations

Aug 29, 2006·Indian Journal of Pediatrics·Ajay R Desai, Akash Deep
Mar 7, 2013·Journal of Clinical Monitoring and Computing·David B BernsteinJason H T Bates
Nov 5, 2010·Indian Pediatrics·Priya Prabhakaran
Sep 22, 2009·American Journal of Physiology. Lung Cellular and Molecular Physiology·Meng ZhangYang Jin
Jun 11, 2011·Pulmonary Medicine·Rajit K Basu, Derek Wheeler
Aug 6, 2020·Journal of Biomolecular Structure & Dynamics·Riadh BadraouiFevzi Bardakci
Apr 17, 2019·International Journal of Molecular Sciences·Yi-Chen LeeShyng-Shiou F Yuan

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