ACUTE RESPIRATORY-DISTRESS SYNDROME IN PE DIATRIC-PATIENTS

Acute respiratory distress syndrome (ARDS) is a frequent condition in pediatric intensive care units. The mortality remains high despite adv ances in conventionnal mechanical ventilation and aetiological treatme nt. Several animal studies have documented lung injury during mechanic al ventilation with high tidal volume, and clinical investigations hav e shown that in human ARDS, most ventilation is distributed to the sma ll areas of remaining aerated lung resulting in overdistension of thes e areas and lung injury (''baby lung'' theory). Nevertheless the usefu lness of extrapulmonary gas exchange remains much debated. New ventila tory strategies have been developped in order to reduce ventilator-ind uced lung injury and to improve systemic oxygenation but multicentric randomized clinical trials are needed before these strategies can be v alidated.