Recent Therapeutic Strategies for Children with Acute Respiratory Distress Syndrome

  • G. Zobel
  • S. Rödl
  • B. Urlesberger


Acute respiratory distress Syndrome (ARDS) was first described in 1967 by Asbough et al. as a clinical Syndrome that occurs 24 to 48 hours after a direct or indirect hing injury [1]. It is characterised by dyspnea, tachypnea, hypoxemia refractory to oxygen therapy, decreased lung compliance, and diffuse alveolar infiltrates on ehest X-ray. ARDS is a rare disorder in childhood. The ineidence varies from 0.8 to 4.4% among all admissions to the pediatric ICU [2–6]. Pediatric literature reports a mortality rate for children with ARDS higher than 50% [7, 8]. An alveolar-arterial oxygen tension difference (P(A-a)02) > 470 mmHg and mean airway pressure (Paw) > 23 cm H20 are associated with poor outcome [5, 8]. Whereas the use of extracorporeal membrane oxygenation (ECMO) significantly increased the survival rate of neonates with severe acute respiratory failure up to 85%, the world wide mortality rate of children with severe ARDS and extracorporeal lung support is still 50% (ELSO report 07/95) [9]. In 1994 the Michigan ECMO group reported a survival rate higher than 80% in children with ARDS and ECMO [10]. Recently, a variety of therapeutic options has been introduced to treat patients with severe ARDS. These novel therapies include pressure controlled mechanical Ventilation with peak pressure limitation < 40 cm H20 [11], permissive hypercapnia [12], inhaled nitric oxide (NO) [13], Surfactant therapy [14], and high frequency oscillation (HFO) [15].


Nitric Oxide Acute Respiratory Distress Syndrome Extracorporeal Membrane Oxygenation Adult Respiratory Distress Syndrome Arterial Oxygen Saturation 


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© Springer-Verlag Italia 1997

Authors and Affiliations

  • G. Zobel
  • S. Rödl
  • B. Urlesberger

There are no affiliations available

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