Ancillary Pulmonary Treatments for Pediatric Acute Respiratory Distress Syndrome

Treatments for pediatric acute respiratory distress syndrome (PARDS) targeting the pulmonary system, other than mechanical ventilation, will be reviewed in this chapter. Many approaches have been used, but unfortunately, there is little medical evidence to guide clinicians in the appropriate use of them. The prone position, inhaled nitric oxide, and surfactant have been studied but have failed to consistently show improved outcomes in children with PARDS. Corticosteroids and the appropriate application of respiratory care, such as pulmonary hygiene, are less well studied. Clinicians are forced to apply limited pediatric research and studies on adult patients to guide the care of children with PARDS. Several therapies may be considered on a case-by-case basis after weighing potential benefits against the risks and costs of the therapy, but no ancillary pulmonary treatment would be considered standard of care in PARDS.