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 Sep 28:11:1216073.
doi: 10.3389/fped.2023.1216073. eCollection 2023.

The perinatal period should be considered in neonatal acute respiratory distress syndrome: comparison of the Montreux definition vs. the second pediatric acute lung injury consensus conference definition

Liting Liu #  1 , Yihan Zhang #  1 , Yiran Wang  1 , Yu He  1 , Xionghui Ding  2 , Long Chen  1 , Yuan Shi  1
Affiliations

The perinatal period should be considered in neonatal acute respiratory distress syndrome: comparison of the Montreux definition vs. the second pediatric acute lung injury consensus conference definition

Liting Liu et al. Front Pediatr. .

Abstract

Background: The recently developed Montreux definition for neonatal acute respiratory distress syndrome (ARDS) partially differs from the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) definition. Here, we compare the Montreux and PALICC-2 definitions regarding morbidity, mortality, and prognosis of neonatal cases of ARDS in order to evaluate which definition is more appropriate for newborns.

Methods: Neonates admitted to our neonatal intensive care unit between 1 January 2018 and 30 September 2019 who met the Montreux or PALICC-2 definition of neonatal ARDS were retrospectively analyzed (n = 472). One comparison was made between application of the Montreux and PALICC-2 definitions to neonates outside the perinatal period (> 7 d after birth). A second comparison was made between a diagnosis of neonatal ARDS within (≤ 7 d of birth) and outside (> 7 d after birth) the perinatal period using the Montreux definition.

Results: No significant differences in morbidity, mortality, severity, therapies, or prognosis were observed between neonates in the extra perinatal group according to the Montreux and PALICC-2 definitions. However, epidemiology, clinical course, and prognosis of neonatal ARDS within the perinatal period did differ from those outside the perinatal period according to the Montreux definition.

Conclusion: Neonates with ARDS within the perinatal period have unique triggers, epidemiology, clinical course, and prognosis, yet a similar pathobiology pattern, to neonates at other ages. Therefore, it may be essential to consider the perinatal period when defining neonatal ARDS.

Keywords: PALICC-2 definition; montreux definition; neonatal ARDS; newborns; perinatal period.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study population selected.
Figure 2
Figure 2
The distribution of patients who met the definition of neonatal ARDS according to the montreux and PALICC-2 definitions. The blue areas represent the 355 neonates who only met the Montreux definition, the dark orange area represents the 99 neonates who met the Montreux and PALICC-2 definitions, and the orange area represents the 18 neonates who only met the PALICC-2 definition.
Figure 3
Figure 3
Severity of neonatal ARDS in the montreux extra perinatal group and the PALICC-2 group.
Figure 4
Figure 4
Severity of neonatal ARDS in the montreux extra perinatal group and the montreux intra perinatal group.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet. (1967) 2:319–23. 10.1016/s0140-6736(67)90168-7 - DOI - PubMed
    1. Gowda MS, Klocke RA. Variability of indices of hypoxemia in adult respiratory distress syndrome. Crit Care Med. (1997) 25:41–5. 10.1097/00003246-199701000-00010 - DOI - PubMed
    1. Villar J, Perez-Mendez L, Lopez J, Belda J, Blanco J, Saralegui I, et al. An early PEEP/FIO2 trial identifies different degrees of lung injury in patients with acute respiratory distress syndrome. Am J Resp Crit Care. (2007) 176:795–804. 10.1164/rccm.200610-1534OC - DOI - PubMed
    1. Ferguson ND, Kacmarek RM, Chiche JD, Singh JM, Hallett DC, Mehta S, et al. Screening of ARDS patients using standardized ventilator settings: influence on enrollment in a clinical trial. Intens Care Med. (2004) 30:1111–6. 10.1007/s00134-004-2163-2 - DOI - PubMed
    1. Pediatric acute respiratory distress syndrome: consensus recommendations from the pediatric acute lung injury consensus conference. Pediatr Crit Care Me. (2015) 16:428–39. 10.1097/PCC.0000000000000350 - DOI - PMC - PubMed