New data on pediatric acute respiratory distress syndrome.

Pediatric acute respiratory distress syndrome (ARDS) manifests clinically a s 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 ventil ation adds to or perpetuates the initial alveolocapillary insult. In patien ts without immunodepression or failure of other organs, the prognosis of pe diatric ARDS has probably been improved by recent advances in ventilatory a ssistance techniques used in pediatric intensive care units. All cause mort ality remains between 30% and 50%. The managment of pediatric ARDS is discu ssed in the light of current pathophysiological concepts. Prospects for fut ure therapeutic improvements are outlined.