New data on pediatric acute respiratory distress syndrome.

Pediatric acute respiratory distress syndrome (ARDS) manifests clinically as acute respiratory failure with hypoxemia requiring ventilatory assistance. The pathogenesis of pediatric ARDS remains controversial. Among the many causes the most common is lower respiratory tract infection, usually due to a virus. There is general agreement that trauma related to assisted ventilation adds to or perpetuates the initial alveolocapillary insult. In patients without immunodepression or failure of other organs, the prognosis of pediatric ARDS has probably been improved by recent advances in ventilatory assistance techniques used in pediatric intensive care units. All cause mortality remains between 30% and 50%. The managment of pediatric ARDS is discussed in the light of current pathophysiological concepts. Prospects for future therapeutic improvements are outlined.