Background: Pediatric acute respiratory distress syndrome (pARDS) is a rare but very severe condition. Management of the condition remains a major challenge for pediatric intensive care specialists. Objective: To perform a descriptive assessment of pARDS based on the modified Berlin Definition by using the SpO 2 /FiO 2 ratio in order to establish an extended patient registry divided into age-related subgroups. Methods: The data of all children on mechanical ventilation for respiratory failure admitted between 2005 and 2012 were reviewed retrospectively for this study. The age of patients ranged from newborns >37 weeks, up to children <18 years. Inclusion criteria were based on the modified Berlin Definition of pARDS. The following data were collected: demographic data, primary diagnosis, ventilation settings, and use of supportive treatment, in addition to mechanical ventilation (inhaled nitric oxide, surfactant, corticosteroids, prone positioning, and extracorporeal membrane oxygenation). Results: In all, 93 children where included: 35% were newborns, 29% infants, 24% toddlers, and 12% school children; 66% were male and 34% were female patients. The most common primary diagnosis was viral pneumonia (21%) and 55% of the children were diagnosed with severe ARDS. The median duration of stay on the pediatric intensive care unit was 16 days (10/27). In total, 66 children (71%) had direct lung injury and 18 (19%) had indirect lung injury. More than 80% of all children needed more than one supportive care therapy. The overall survival rate was 77%. Conclusion: This study is a valuable report about pediatric patients with ARDS and allows for an important extension of the application of the modified Berlin Definition in all age groups.
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Hermon, M., Dotzler, S., Brandt, J. B., Strohmaier, W., & Golej, J. (2019). Extended use of the modified Berlin Definition based on age-related subgroup analysis in pediatric ARDS. Wiener Medizinische Wochenschrift, 169(3–4), 93–98. https://doi.org/10.1007/s10354-018-0659-6