Pediatric Acute Respiratory Distress Syndrome—Will We Be Able to Predict It and Eventually Prevent It?*

Ciomârtan, Tatiana

doi:10.1097/ccm.0000000000005324

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…In particular, it is suggested that early prone position ventilation in patients with severe ARDS may improve pulmonary ventilatory blood flow ratio, promote sputum drainage and reduce mortality ( 6 ). However, there is no definite evidence that prone position ventilation can improve the prognosis of children with ARDS ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Prone position in the mechanical ventilation of acute respiratory distress syndrome children: a systematic review and meta-analysis

Qin,

Mao,

Shen

et al. 2024

Front. Pediatr.

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BackgroundProne position has been well recognized for the treatment of adult acute respiratory distress syndrome (ARDS). We aimed to evaluate the role of prone position in the mechanical ventilation in children with ARDS, to provide evidence to the treatment and care of children with ARDS.MethodsWe searched the Pubmed et al. databases by computer until January 23, 2024 for randomized controlled trials (RCTs) on the role of prone position in the mechanical ventilation in children with ARDS. We evaluated the quality of included studies according to the quality evaluation criteria recommended by the Cochrane library. RevMan 5.3 software was used for meta-analysis.Results7 RCTs involving 433 children with ARDS were included. Meta-analysis indicated that prone position is beneficial to improve the arterial oxygenation pressure [MD = 4.27 mmHg, 95% CI (3.49, 5.06)], PaO2/FiO2 [MD = 26.97, 95% CI (19.17, 34.77)], reduced the oxygenation index [MD = −3.52, 95% CI (−5.41, −1.64)], mean airway pressure [MD = −1.91 cmH2O, 95% CI (−2.27, −1.55)] and mortality [OR = 0.33, 95% CI (0.15, 0.73), all P < 0.05]. There were no statistical differences in the duration of mechanical ventilation between the prone position group and control group [MD = −17.01, 97.27, 95% CI (−38.28, 4.26), P = 0.12]. Egger test results showed that no significant publication bias was found (all P > 0.05).ConclusionsProne position ventilation has obvious advantages in improving oxygenation, but there is no significant improvement in the time of mechanical ventilation in the treatment of children with ARDS. In the future, more large-sample, high-quality RCTs are still needed to further analyze the role of prone position in the mechanical ventilation in children with ARDS.

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Section: Introductionmentioning

confidence: 99%

Prone position in the mechanical ventilation of acute respiratory distress syndrome children: a systematic review and meta-analysis

Qin,

Mao,

Shen

et al. 2024

Front. Pediatr.

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“…Among children hospitalized in the neonatal intensive care unit (NICU), the morbidity and mortality of neonatal ARDS is high 2 . Its clinical manifestations are shortness of breath, respiratory distress, hypoxemia, decreased light transmittance in both lungs and even white lung 3 . As an essential micronutrient for human metabolism, vitamin A (VA) can participate in early fetal lung development and affect lung immune function 4 .…”

Section: Introductionmentioning

confidence: 99%

Integration of multiomics analysis to reveal the major pathways of vitamin A deficiency aggravates acute respiratory distress syndrome in neonatal rats

Tang,

Yuan,

Sun

et al. 2023

Sci Rep

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Acute respiratory distress syndrome (ARDS) is a major disease that threatens the life and health of neonates. Vitamin A (VA) can participate in early fetal lung development and affect lung immune function. Researches revealed that the serum VA level in premature infants with ARDS was lower than that in premature infants without ARDS of the same gestational age, and premature infants with VA deficiency (VAD) were more likely to develop ARDS. Moreover, the VA levels can be used as a predictor of the development and severity of neonatal ARDS. However, the critical question here is; Does ARDS develop due to VAD in these systemic diseases? Or does ARDS develop because these diseases cause VAD? We hypothesize that VAD may aggravate neonatal ARDS by affecting immunity, metabolism, barriers and other pathways. In this article, we used multiomics analysis to find that VAD may aggravate ARDS mainly through the Fc epsilon RI signaling pathway, the HIF-1 signaling pathway, glutathione metabolism, and valine, leucine and isoleucine degradation signaling pathways, which may provide the molecular pathogenic mechanism behind the pathology of VAD-aggravated ARDS and can also provide potential molecular targets for subsequent research on ARDS.

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Pediatric Acute Respiratory Distress Syndrome—Will We Be Able to Predict It and Eventually Prevent It?*

Cited by 2 publications

References 19 publications

Prone position in the mechanical ventilation of acute respiratory distress syndrome children: a systematic review and meta-analysis

Prone position in the mechanical ventilation of acute respiratory distress syndrome children: a systematic review and meta-analysis

Integration of multiomics analysis to reveal the major pathways of vitamin A deficiency aggravates acute respiratory distress syndrome in neonatal rats

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