TY - JOUR
T1 - Noninvasive Respiratory Support for Pediatric Acute Respiratory Distress Syndrome
T2 - From the Second Pediatric Acute Lung Injury Consensus Conference
AU - Carroll, Christopher L
AU - Napolitano, Natalie
AU - Pons-Òdena, Marti
AU - Iyer, Narayan Prabhu
AU - Korang, Steven Kwasi
AU - Essouri, Sandrine
AU - Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
N1 - Copyright © 2023 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - OBJECTIVES: To develop evidence-based recommendations for the Second Pediatric Acute Lung Injury Consensus Conference (PALICC) regarding the effectiveness of noninvasive respiratory support for pediatric acute respiratory distress syndrome (PARDS). These include consideration of the timing and duration of noninvasive ventilation (NIV) and high-flow nasal cannula (HFNC), whether effectiveness varies by disease severity or by characteristics of treatment delivery, and best practices for the use of NIV.DATA SOURCES: MEDLINE (Ovid), Embase (Elsevier), and CINAHL Complete (EBSCOhost).STUDY SELECTION: Searches included all studies involving the use of NIV or HFNC in children with PARDS or hypoxemic respiratory failure.DATA EXTRACTION: Title/abstract review, full-text review, and data extraction using a standardized data extraction form.DATA SYNTHESIS: The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize evidence and develop recommendations. Out of 6,336 studies, we identified 187 for full-text review. Four clinical recommendations were generated, related to indications, timing and duration of NIV in patients with PARDS, predictors of NIV failure and need for intubation (signs and symptoms of worsening disease including pulse oximetry saturation/Fio2 ratio), and use of NIV in resource-limited settings. Six good practice statements were generated related to how and where to deliver NIV, the importance of trained experienced staff and monitoring, types of NIV interfaces, the use of sedation, and the potential complications of this therapy. One research statement was generated related to indications of HFNC in patients with PARDS.CONCLUSIONS: NIV is a widely used modality for the treatment of respiratory failure in children and may be beneficial in a subset of patients with PARDS. However, there needs to be close monitoring for worsening disease and NIV failure.
AB - OBJECTIVES: To develop evidence-based recommendations for the Second Pediatric Acute Lung Injury Consensus Conference (PALICC) regarding the effectiveness of noninvasive respiratory support for pediatric acute respiratory distress syndrome (PARDS). These include consideration of the timing and duration of noninvasive ventilation (NIV) and high-flow nasal cannula (HFNC), whether effectiveness varies by disease severity or by characteristics of treatment delivery, and best practices for the use of NIV.DATA SOURCES: MEDLINE (Ovid), Embase (Elsevier), and CINAHL Complete (EBSCOhost).STUDY SELECTION: Searches included all studies involving the use of NIV or HFNC in children with PARDS or hypoxemic respiratory failure.DATA EXTRACTION: Title/abstract review, full-text review, and data extraction using a standardized data extraction form.DATA SYNTHESIS: The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize evidence and develop recommendations. Out of 6,336 studies, we identified 187 for full-text review. Four clinical recommendations were generated, related to indications, timing and duration of NIV in patients with PARDS, predictors of NIV failure and need for intubation (signs and symptoms of worsening disease including pulse oximetry saturation/Fio2 ratio), and use of NIV in resource-limited settings. Six good practice statements were generated related to how and where to deliver NIV, the importance of trained experienced staff and monitoring, types of NIV interfaces, the use of sedation, and the potential complications of this therapy. One research statement was generated related to indications of HFNC in patients with PARDS.CONCLUSIONS: NIV is a widely used modality for the treatment of respiratory failure in children and may be beneficial in a subset of patients with PARDS. However, there needs to be close monitoring for worsening disease and NIV failure.
KW - Acute Lung Injury
KW - Cannula
KW - Child
KW - Humans
KW - Intubation
KW - Noninvasive Ventilation
KW - Oxygen Inhalation Therapy
KW - Respiration, Artificial
KW - Respiratory Distress Syndrome/therapy
KW - Respiratory Insufficiency/therapy
KW - noninvasive ventilation
KW - continuous positive airway pressure
KW - pediatric acute respiratory distress syndrome
KW - pediatric critical care
KW - pediatrics
KW - acute respiratory distress syndrome
UR - http://www.scopus.com/inward/record.url?scp=85146832630&partnerID=8YFLogxK
U2 - 10.1097/PCC.0000000000003165
DO - 10.1097/PCC.0000000000003165
M3 - Review
C2 - 36661442
SN - 1529-7535
VL - 24
SP - S135-S147
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 12 Suppl 2
ER -