PALICC definition of ARDS. Don’t remove that brick from the wall and keep it smart and simple

Medina, Alberto; Alapont, V. Modesto i; Villar-Guerra, Pablo del

doi:10.1016/j.medine.2015.12.003

Cited by 2 publications

(7 citation statements)

References 9 publications

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“…Medina et al discussed that because all scientific data on ARDS prognosis and treatment were based on bilateral disease, we need more studies to include unilateral ARDS. 9 A limitation of the current study is that only patients who died and underwent pathological pulmonary investigation were included in the study. Thus, our group represents patients with the severest prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…DAD was diagnosed with presence of hyaline membranes, alveolar cell type I or endothelial cell necrosis, edema, and organizing interstitial fibrosis. 9,10 Inflammation and congestion were also added as parameters. The severity of these parameters was graded by four levels, 4 being diffuse and intense in all lobes, 3 being local manifestations in all lobes, 2 being diffuse involvement of three lobes, and 1 being focal presence in one or two lobes.…”

Section: Pathological Examinationmentioning

confidence: 99%

“…However, the PALICC definition still needs validation, and there are opinions against the sufficiency of unilateral infiltration and the use of OI to measure intrapulmonary shunts. 9 The morphological hallmark of ARDS is diffuse alveolar damage (DAD) with disruption of the alveolocapillary unit, described by Katzenstein et al 10 Alveolocapillary unit is damaged. Histopathologically, hyaline membrane formation, alveolar cell type I or endothelial cell necrosis, edema, fibrosis, and alveolar cell type II proliferation are seen.…”

Section: Introductionmentioning

confidence: 99%

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Diffuse Alveolar Damage Correlation with Clinical Diagnosis of Pediatric Acute Respiratory Distress Syndrome

Serdaroğlu

Kesici

Bayrakçı

et al. 2020

J Pediatr Intensive Care

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Diffuse alveolar damage (DAD) is one of the pathological hallmarks of acute respiratory distress syndrome (ARDS). We aimed to compare pathological findings of DAD with clinical ARDS criteria. We re-evaluated 20 patients whose clinical autopsy revealed DAD. Total 11/20 patients with DAD (55%) met the 1994 American–European Consensus Conference and 7/17 (41%) met the 2012 Berlin clinical criteria. DAD showed only moderate correlation with current clinical ARDS definition. Oxygenation index (OI), seems to be the most valuable tool in predicting pulmonary damage severity, though OI is not listed in either of the previous definitions. We support the recommended use of OI by 2015 consensus conference.

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Section: Discussionmentioning

confidence: 99%

Section: Pathological Examinationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diffuse Alveolar Damage Correlation with Clinical Diagnosis of Pediatric Acute Respiratory Distress Syndrome

Serdaroğlu

Kesici

Bayrakçı

et al. 2020

J Pediatr Intensive Care

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“…Data pertaining to demographic profile, clinical outcomes, and respiratory support were collected from case notes and electronic records. Severity of PARDS was graded into mild, moderate, or severe according to PALICC classification 18 . Pediatric index of mortality 2 (PIM2) score was calculated on admission to PICU 19 …”

Section: Methodsmentioning

confidence: 99%

“…17 Definition of PARDS was refined in 2015 by PALICC work group. 18 This definition required the presence of new infiltrates on chest imaging and stratified patients into mild, moderate, and severe PARDS based on oxygenation index (OI). Clinical charts of identified patients were then examined to ensure that these patients fulfilled PALICC definition of PARDS.…”

Section: Patientsmentioning

confidence: 99%

High burden of acquired morbidity in survivors of pediatric acute respiratory distress syndrome

Loh

Gan

Wong

et al. 2021

Pediatric Pulmonology

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Introduction: With improving mortality rates in pediatric acute respiratory distress syndrome (PARDS), functional outcomes in survivors are increasingly important. We aim to describe the change in functional status score (FSS) from baseline to discharge and to identify risk factors associated with poor functional outcomes.Methods: We examined clinical records of patients with PARDS admitted to our pediatric intensive care unit (PICU) from 2009 to 2016. Our primary outcome was acquired morbidity at PICU and hospital discharge (defined by an increase in FSS ≥3 points above baseline). We included severity of illness scores and severity of PARDS in our bivariate analysis for risk factors for acquired morbidity.Results: There were 181 patients with PARDS, of which 90 (49.7%) survived.Median pediatric index of mortality 2 score was 4.05 (1.22, 8.70) and 21 (23.3%) survivors had severe PARDS. A total of 59 (65.6%) and 14 (15.6%) patients had acquired morbidity at PICU and hospital discharge, respectively. Median baseline FSS was 6.00 (6.00, 6.25), which increased to 11.00 (8.75, 12.00) at PICU discharge before decreasing to 7.50 (6.00, 9.25) at hospital discharge. All patients had significantly higher FSS at both PICU and hospital discharge median compared to baseline. Feeding and respiratory were the most affected domains. After adjusting for severity of illness, severity categories of PARDS were not a risk factor for acquired morbidity.Conclusion: Acquired morbidity in respiratory and feeding domains was common in PARDS survivors. Specific attention should be given to these two domains of functional outcomes in these children.

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PALICC definition of ARDS. Don’t remove that brick from the wall and keep it smart and simple

Cited by 2 publications

References 9 publications

Diffuse Alveolar Damage Correlation with Clinical Diagnosis of Pediatric Acute Respiratory Distress Syndrome

Diffuse Alveolar Damage Correlation with Clinical Diagnosis of Pediatric Acute Respiratory Distress Syndrome

High burden of acquired morbidity in survivors of pediatric acute respiratory distress syndrome

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