Cheifetz Ira M
Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710.
Respir Care. 2017 Jun;62(6):718-731. doi: 10.4187/respcare.05591.
The Pediatric Acute Lung Injury Consensus Conference (PALICC) has provided the critical care community with the first pediatric-focused definition for ARDS. The PALICC recommendations provide guidance on conventional ventilator management, gas exchange goals, use of high-frequency ventilation, adjunct management approaches, and the application of extracorporeal membrane oxygenation for pediatric ARDS (PARDS). Although outcomes for PARDS have improved over the past decade, mortality and morbidity remain significant. Pediatric-specific criteria may provide the ability to more promptly recognize and diagnose PARDS in clinical practice. Improvements in prognostication and stratification of disease severity may help to guide therapeutic interventions. Improved comparisons between patients and studies may help to promote future clinical investigations. Hopefully, the recommendations provided by PALICC, in terms of defining and managing ARDS, will stimulate additional research to better guide therapy and further improve outcomes for critically ill infants and children with ARDS.
小儿急性肺损伤共识会议（PALICC）为重症监护领域提供了首个针对儿童的急性呼吸窘迫综合征（ARDS）定义。PALICC的建议为小儿ARDS（PARDS）的传统通气管理、气体交换目标、高频通气的使用、辅助管理方法以及体外膜肺氧合的应用提供了指导。尽管在过去十年中PARDS的治疗效果有所改善，但死亡率和发病率仍然很高。儿科特定标准可能使临床实践中更迅速地识别和诊断PARDS成为可能。疾病严重程度的预后评估和分层的改善可能有助于指导治疗干预。患者与研究之间更好的比较可能有助于推动未来的临床研究。希望PALICC在定义和管理ARDS方面提供的建议将激发更多研究，以更好地指导治疗，并进一步改善患有ARDS的危重症婴幼儿的治疗效果。
