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Review
. 2024 Oct 12;11(10):1232.
doi: 10.3390/children11101232.

Acute Respiratory Failure in Children: A Clinical Update on Diagnosis

Beatrice Panetti  1 , Ilaria Bucci  1 , Armando Di Ludovico  1 , Giulia Michela Pellegrino  2 , Paola Di Filippo  1 , Sabrina Di Pillo  1 , Francesco Chiarelli  1 , Marina Attanasi  1 , Giuseppe Francesco Sferrazza Papa  2
Affiliations
Review

Acute Respiratory Failure in Children: A Clinical Update on Diagnosis

Beatrice Panetti et al. Children (Basel). .

Abstract

Acute respiratory failure (ARF) is a sudden failure of the respiratory system to ensure adequate gas exchanges. Numerous clinical conditions may cause ARF, including pneumonia, obstructive lung diseases (e.g., asthma), restrictive diseases such as neuromuscular diseases (e.g., spinal muscular atrophy and muscular dystrophy), and albeit rarely, interstitial lung diseases. Children, especially infants, may be more vulnerable to ARF than adults due to anatomical and physiological features of the respiratory system. Assessing respiratory impairment in the pediatric population is particularly challenging as children frequently present difficulties in reporting symptoms and due to compliance and cooperation in diagnostic tests. The evaluation of clinical and anamnestic aspects represents the cornerstone of ARF diagnosis: first level exams (e.g., arterial blood gas analysis) confirm and evaluate the severity of the ARF and second level exams help to uncover the underlying cause. Prompt management is critical, with supplemental oxygen, mechanical ventilation, and the treatment of the underlying problem. The aim of this review is to provide a comprehensive summary of the current state of the art in diagnosing pediatric ARF, with a focus on pathophysiology, novel imaging applications, and new perspectives, such as biomarkers and artificial intelligence.

Keywords: acute respiratory failure; artificial intelligence; biomarkers; chest X-ray; chest computed tomography; children; lung function; lung magnetic resonance imaging; lung ultrasound.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Pathophysiology of acute respiratory failure in infants and young children.
Figure 2
Figure 2
The main causes of ARF in children.
See this image and copyright information in PMC

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