1. Pediatric ARDS: Understanding It and Managing It James D. Fortenberry, MD Medical Director, Pediatric and Adult ECMO Medical Director, Critical Care Medicine Children’s Healthcare of Atlanta at Egleston
2. New and Improved Adult Respiratory Distress Syndrome Acute Respiratory Distress Syndrome
45. ARDS- “Mechanical” Therapies Prone positioning - Unproven outcome benefit Low tidal volumes - Outcome benefit in large study Open-lung strategy - Outcome benefit in small study HFOV -Outcome benefit in small study ECMO - Proven in neonates unproven in children
46. Pharmacologic Approaches to ARDS: Randomized Trials Glucocorticoids Fibrosing alveolitis - lowered mortality, small study Surfactant - possible benefit in children Inhaled NO - no benefit Partial liquid ventilation - no benefit
47. “…We must discard the old approach and continue to search for ways to improve mechanical ventilation. In the meantime, there is no substitute for the clinician standing by the ventilator…” - Martin J. Tobin, MD