scholarly journals Severe pediatric COVID-19 with acute respiratory distress syndrome: a narrative review

2021 ◽  
Vol 0 ◽  
pp. 0-0
Author(s):  
Huixian Wang ◽  
Yuanyuan Qi ◽  
Liling Qian
2019 ◽  
Vol 32 (3) ◽  
pp. 347-360 ◽  
Author(s):  
Mitchell S. Buckley ◽  
Amy L. Dzierba ◽  
Justin Muir ◽  
Jeffrey P. Gonzales

Acute respiratory distress syndrome (ARDS) remains a common complication associated with significant negative outcomes in critically ill patients. Lung-protective mechanical ventilation strategies remain the cornerstone in the management of ARDS. Several therapeutic options are currently available including fluid management, neuromuscular blocking agents, prone positioning, extracorporeal membrane oxygenation, corticosteroids, and inhaled pulmonary vasodilating agents (prostacyclins and nitric oxide). Unfortunately, an evidence-based, standard-of-care approach in managing ARDS beyond lung-protective ventilation remains elusive, contributing to significant variability in clinical practice. Although the optimal therapeutic strategy for managing moderate to severe ARDS remains extremely controversial, therapies supported with more robust clinical evidence should be considered first. The purpose of this narrative review is to discuss the published clinical evidence for both pharmacologic and nonpharmacologic management strategies in adult patients with moderate to severe ARDS as well as to discuss practical considerations for implementation.


2018 ◽  
Vol 21 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Maryam Malek ◽  
Jalal Hassanshahi ◽  
Reza Fartootzadeh ◽  
Fatemeh Azizi ◽  
Somayeh Shahidani

2020 ◽  
Vol 131 (5) ◽  
pp. 1471-1484
Author(s):  
Lisa K. Lee ◽  
Lejla Medzikovic ◽  
Mansoureh Eghbali ◽  
Holger K. Eltzschig ◽  
Xiaoyi Yuan

Author(s):  
Inna Krynytska ◽  
Mariya Marushchak ◽  
Inna Birchenko ◽  
Alina Dovgalyuk ◽  
Oleksandr Tokarskyy

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, Severe Acute Respiratory Syndrome-Coronavi- rus-2 (SARS-CoV-2), led to the ongoing global public health crisis. Existing clinical data suggest that COVID-19 patients with acute respiratory distress syndrome (ARDS) have worse outcomes and increased risk of intensive care unit (ICU) admission. The rapid increase in the numbers of patients requiring ICU care may imply a sudden and major challenge for affected health care systems. In this narrative review, we aim to summarize current knowledge of pathophysiology, clinical and morphological characteristics of COVID-19-associated ARDS and ARDS caused by other factors (classical ARDS) as defined by Berlin criteria, and therefore to elucidate the differences, which can affect clinical management of COVID-19-as- sociated ARDS. Fully understanding the characteristics of COVID-19-associated ARDS will help identify its early progres- sion and tailor the treatment, leading to improved prognosis in severe cases and reduced mortality. The notable mechanisms of COVID-19-associated ARDS include severe pulmonary infiltration/edema and inflammation, leading to impaired alveolar homeostasis, alteration of pulmonary physiology resulting in pulmonary fibrosis, endothelial inflammation and vascular thrombosis. Despite some distinct differences between COVID-19-associated ARDS and classical ARDS as defined by Ber- lin criteria, general treatment principles, such as lung-protective ventilation and rehabilitation concepts should be applied whenever possible. At the same time, ventilatory settings for COVID-19-associated ARDS require to be adapted in individ- ual cases, depending on respiratory mechanics, recruitability and presentation timing.  


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