Objectives: To review articles relevant to the field of pediatric respiratory disease that were published after the 2008 Rogers' Textbook of Pediatric Intensive Care.
Data Sources: The authors searched the PubMed database (http://www.ncbi.nlm.nih.gov/sites/entrez) from the National Library of Medicine for citations from the pediatric and adult literature relevant to pediatric status asthmaticus, bronchiolitis, pneumonia, acute lung injury, acute respiratory distress syndrome, and neonatal respiratory failure. The authors also searched the reference lists of key primary publications and recent review articles, and queried the National Institutes of Health's ClinicalTrials.gov Web site (www.clinicaltrials.gov) to obtain information about ongoing clinical trials for acute lung injury. The authors had knowledge of new publications in the field of respiratory monitoring, which were considered for inclusion in the review.
Study Selection and Data Extraction: The authors reviewed the promising articles and the decision to include any article in the review was based on its potential to inform pediatric intensive care practice or future research.
Data Synthesis: Articles in six categories were selected for inclusion: status asthmaticus, bronchiolitis, pneumonia, acute lung injury/acute respiratory distress syndrome, respiratory monitoring, and neonatal respiratory failure.
Conclusions: There have been important new developments relevant to the pathogenesis and management of pediatric respiratory diseases. In particular, new insights into the causal pathways of respiratory syncytial virus-induced airways disease can potentially lead to novel therapies. Computed tomography imaging of the injured lung during mechanical ventilation has opened new avenues for future research directed at testing new treatments in acute lung injury subpopulations defined according to lung mechanics. Promising new monitoring techniques may play a supporting role in the conduct of these studies. Finally, evidence from the neonatal literature recently has shown how the course and future consequences of respiratory failure in this population may be modified through more widespread use of noninvasive support.
From the Section of Critical Care Medicine (KMV), The Children's Hospital, Denver, CO, and the Department of Pediatrics, University of Colorado School of Medicine, Aurora CO; Division of Critical Care Medicine (GKW, JHA), Department of Anesthesia, Perioperative and Pain Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA.
Dr. Arnold received grant support from Masimo and received honoraria/speaking fees from Ikaria. The remaining authors have not disclosed any potential conflicts of interest.
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