Webb Lece, Burton Luke, Manchikalapati Ananya, Prabhakaran Priya, Loberger Jeremy M, Richter Robert P
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States.
Division of Pediatric Critical Care, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States.
Front Med (Lausanne). 2023 Aug 16;10:1216538. doi: 10.3389/fmed.2023.1216538. eCollection 2023.
Severe acute respiratory distress syndrome in children, or PARDS, carries a high risk of morbidity and mortality that is not fully explained by PARDS severity alone. Right ventricular (RV) dysfunction can be an insidious and often under-recognized complication of severe PARDS that may contribute to its untoward outcomes. Indeed, recent evidence suggest significantly worse outcomes in children who develop RV failure in their course of PARDS. However, in this narrative review, we highlight the dearth of evidence regarding the incidence of and risk factors for PARDS-associated RV dysfunction. While we wish to draw attention to the absence of available evidence that would inform recommendations around surveillance and treatment of RV dysfunction during severe PARDS, we leverage available evidence to glean insights into potentially helpful surveillance strategies and therapeutic approaches.
儿童重症急性呼吸窘迫综合征（PARDS）具有较高的发病和死亡风险，而这不能仅用PARDS的严重程度来完全解释。右心室（RV）功能障碍可能是严重PARDS的一种隐匿且常未被充分认识的并发症，可能导致不良后果。事实上，最近的证据表明，在PARDS病程中出现RV衰竭的儿童预后明显更差。然而，在这篇叙述性综述中，我们强调了关于PARDS相关RV功能障碍的发生率和危险因素的证据不足。虽然我们希望提请注意缺乏可用于指导严重PARDS期间RV功能障碍监测和治疗建议的现有证据，但我们利用现有证据来深入了解潜在有用的监测策略和治疗方法。
