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

2020 ◽  
Author(s):  
Esra Serdaroglu ◽  
Selman Kesici ◽  
Benan Bayrakci ◽  
Gulsev Kale
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Oxygenation Index ◽  
Consensus Conference ◽  
Clinical Criteria ◽  
European Consensus ◽  
Pulmonary Damage

AbstractDiffuse 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.

Therapeutic strategy in acute respiratory distress syndrome

2016 ◽  
Author(s):  
Charlotte Summers ◽  
Geoffrey Bellingan
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Therapeutic Strategy ◽  
Distress Syndrome ◽  
Consensus Conference ◽  
Lung Protective Ventilation ◽  
Fluid Restriction ◽  
European Consensus ◽  
Made In

Acute respiratory distress syndrome (ARDS) is a pathological syndrome characterized by arterial hypoxaemia and bilateral pulmonary infiltrates. Until recently, the diagnosis of ARDS was made in accordance with the American–European Consensus Conference criteria established in 1994, although an updated ‘Berlin’ definition was produced in 2012. It is important to remember that ARDS is not a single disease, but rather a constellation of conditions with similar pathophysiology, and thus there may not be one unifying clinical treatment. The mainstay of ARDS management is the identification and treatment of the predisposing condition, surveillance for the presence of intercurrent infection, and supportive care, including lung-protective ventilation, and even prone ventilation in more severe cases. Fluid restriction, after patients are appropriately resuscitated, is probably of benefit. Despite many clinical trials, there are currently no licensed pharmacological therapies for ARDS, however a number of novel agents are under development.

scholarly journals Fatal acute respiratory distress syndrome with diffuse alveolar damage: donor lymphocyte infusion imputability?

2016 ◽  
Vol 48 (6) ◽  
pp. 1794-1796 ◽  
Author(s):  
Colombe Saillard ◽  
Magali Bisbal ◽  
Antoine Sannini ◽  
Laurent Chow-Chine ◽  
Jean-Paul Brun ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Donor Lymphocyte Infusion

Acute Kidney Injury in Pediatric Acute Respiratory Distress Syndrome

2020 ◽  
pp. 088506662094404
Author(s):  
Shubhi Kaushik ◽  
Sindy Villacres ◽  
Ruth Eisenberg ◽  
Shivanand S. Medar
Keyword(s):  
Acute Kidney Injury ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Invasive Mechanical Ventilation ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Oxygenation Index ◽  
Significant Difference

Objectives: To describe the incidence of and risk factors for acute kidney injury (AKI) in children with acute respiratory distress syndrome (ARDS) and study the effect of AKI on patient outcomes. Design: A single-center retrospective study. Setting: A tertiary care children’s hospital. Patients: All patients less than 18 years of age who received invasive mechanical ventilation (MV) and developed ARDS between July 2010 and July 2013 were included. Acute kidney injury was defined using p-RIFLE (risk, injury, failure, loss, and end-stage renal disease) criteria. Interventions: None. Measurements and Main Results: One hundred fifteen children met the criteria and were included in the study. Seventy-four children (74/115, 64%) developed AKI. The severity of AKI was risk in 34 (46%) of 74, injury in 19 (26%) of 74, and failure in 21 (28%) of 74. The presence of AKI was associated with lower Pao 2 to Fio 2 (P/F) ratio ( P = .007), need for inotropes ( P = .003), need for diuretics ( P = .004), higher oxygenation index ( P = .03), higher positive end-expiratory pressure (PEEP; P = .01), higher mean airway pressure ( P = .008), and higher Fio 2 requirement ( P = .03). Only PEEP and P/F ratios were significantly associated with AKI in the unadjusted logistic regression model. Patients with AKI had a significantly longer duration of hospital stay, although there was no significant difference in the intensive care unit stay, duration of MV, and mortality. Recovery of AKI occurred in 68% of the patients. A multivariable model including PEEP, P/F ratio, weight, need for inotropes, and need for diuretics had a better receiver operating characteristic (ROC) curve with an AUC of 0.75 compared to the ROC curves for PEEP only and P/F ratio only for the prediction of AKI. Conclusions: Patients with ARDS have high rates of AKI, and its presence is associated with increased morbidity and mortality.

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