Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 1;24(12 Suppl 2):S87-S98.
doi: 10.1097/PCC.0000000000003161. Epub 2023 Jan 20.

Definition, Incidence, and Epidemiology of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Nadir Yehya  1   2 , Lincoln Smith  3 , Neal J Thomas  4 , Katherine M Steffen  5 , Jerry Zimmerman  3 , Jan Hau Lee  6 , Simon J Erickson  7 , Steven L Shein  8 ; Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
Collaborators, Affiliations

Definition, Incidence, and Epidemiology of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Nadir Yehya et al. Pediatr Crit Care Med. .

Abstract

Objectives: In 2015, the Pediatric Acute Lung Injury Consensus Conference (PALICC) provided the first pediatric-specific definitions for acute respiratory distress syndrome (pediatric acute respiratory distress syndrome [PARDS]). These definitions have since been operationalized in cohort and interventional PARDS studies. As substantial data have accrued since 2015, we have an opportunity to assess the construct validity and utility of the initial PALICC definitions. Therefore, the Second PALICC (PALICC-2) brought together multiple PARDS experts and aimed to identify and summarize relevant evidence related to the definition and epidemiology of PARDS and create modifications to the definition of PARDS.

Data sources: MEDLINE (Ovid), Embase (Elsevier), and CINAHL Complete (EBSCOhost).

Study selection: We included studies of subjects with PARDS, or at risk for PARDS, excluding studies pertaining primarily to adults except as specified for identifying age-specific cutoffs.

Data extraction: Title/abstract review, full-text review, and data extraction using a standardized data collection form.

Data synthesis: The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize evidence and develop recommendations. A total of 97 studies were identified for full-text extraction addressing distinct aspects of the PARDS definition, including age, timing, imaging, oxygenation, modes of respiratory support, and specific coexisting conditions. Data were assessed in a Patient/Intervention/Comparator/Outcome format when possible, and formally summarized for effect size, risk, benefit, feasibility of implementation, and equity. A total of 17 consensus-based definition statements were made that update the definition of PARDS, as well as the related diagnoses of "Possible PARDS" and "At-Risk for PARDS." These statements are presented alongside a summary of the relevant epidemiology.

Conclusions: We present updated, data-informed consensus statements on the definition for PARDS and the related diagnoses of "Possible PARDS" and "At-Risk for PARDS."

PubMed Disclaimer

Conflict of interest statement

Dr. Yehya’s institution received funding from the National Heart, Lung, and Blood Institute; he received support for article research from the National Institutes of Health. Dr. Lee’ s institution received funding from the National Research Medical Council, Singapore. Dr. Shein received funding from Hill Ward Henderson Law Firm. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

    1. Khemani RG, Smith LS, Zimmerman JJ, et al.; Pediatric Acute Lung Injury Consensus Conference Group: Pediatric acute respiratory distress syndrome: Definition, incidence, and epidemiology: Proceedings from the pediatric acute lung injury consensus conference. Pediatr Crit Care Med 2015; 16:S23–S40
    1. Bernard GR, Artigas A, Brigham KL, et al.: The American-European consensus conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994; 149:818–824
    1. Force ADT, Ranieri VM, Rubenfeld GD, et al.: Acute respiratory distress syndrome: The Berlin definition. JAMA 2012; 307:2526–2533
    1. Iyer N, Khemani R, Emeriaud G, et al.; Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) for the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network: Methodology of the second pediatric acute lung injury consensus conference. Pediatr Crit Care Med 2023; 24 (Suppl 1):S76–S86
    1. De Luca D, Tingay DG, van Kaam AH, et al.: Epidemiology of neonatal acute respiratory distress syndrome: Prospective, multicenter, international cohort study. Pediatr Crit Care Med 2022; 23:524–534

LinkOut - more resources