Russian Journal of Pediatric Surgery, Anesthesia and Intensive CareRussian Journal of Pediatric Surgery, Anesthesia and Intensive CareРоссийский вестник детской хирургии, анестезиологии и реаниматологии2219-40612587-6554Eco-Vector156910.17816/psaic1569ReviewsОбзорыReview ArticleAcute respiratory distress syndrome in pediatric practice, diagnosis, and intensive care: A reviewОстрый респираторный дистресс-синдром в педиатрической практике: диагностика и интенсивная терапия. Обзор литературы儿科急性呼吸窘迫综合征：诊断和重症监护。 文献综述https://orcid.org/0000-0002-2131-48132225-1630AleksandrovichYurii S.АлександровичЮрий СтаниславовичAleksandrovichYurii S.
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

MD, Dr. Sci. (Medicine), Professor

Jalex1963@mail.ruhttps://orcid.org/0000-0003-1113-52968423-4294PshenisnovKonstantin V.ПшенисновКонстантин ВикторовичPshenisnovKonstantin V.
Russian Federation

MD, Dr. Sci. (Medicine), Assistant Professor

д-р мед. наук, доцент

MD, Dr. Sci. (Medicine), Assistant Professor

Psh_K@mail.ruhttps://orcid.org/0000-0002-2451-12147176-8584KolodyazhnayaViktoriya I.КолодяжнаяВиктория ИгоревнаKolodyazhnayaViktoriya I.
Russian Federation
vi.kolodyazhnaya@gmail.comSaint Petersburg State Pediatric Medical UniversityСанкт-Петербургский государственный педиатрический медицинский университетSaint Petersburg State Pediatric Medical University1104202414183950911202308022024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-ВекторCopyright ©; 2024,2024Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://rps-journal.ru/jour/article/view/1569

Acute respiratory distress syndrome is one of the main causes of life-threatening complications and deaths in pediatric intensive care units. This study aimed to analyze the current features of epidemiology, risk factors, and outcomes of acute respiratory distress syndrome in children aged >1 months according to the literature. The analysis included 100 publications extracted from eLibrary and PubMed abstract databases. The search was performed using the following keywords: acute respiratory distress syndrome, epidemiology, pediatric, outcome, and control mechanical ventilation. After the initial study of abstracts, 64 articles containing previously published information were excluded from the review. The recommendations of the Pediatric Acute Lung Injury Consensus Conference, which were published in April 2023, were taken as the main source. The review presents current definitions, risk factors, and criteria for the severity of acute respiratory distress syndrome in pediatric practice, discusses in detail the features of invasive ventilation and adjuvant therapy, and pays special attention to infusion and transfusion therapy, nutrition, and sedation. One of the sections is devoted to monitoring the patient’s condition, assessing the effectiveness of gas exchange and hemodynamics, and emphasizing the importance of a dynamic assessment of delirium in patients and the readiness for extubation. The recommendations of Pediatric Acute Lung Injury Consensus Conference-2 for the treatment of acute respiratory distress syndrome in children make it possible to more accurately stratify the severity of the pathological process, identify patients at risk with a high probability of developing this syndrome, and begin timely protective respiratory support to restore lung parenchyma and optimize oxygen delivery and consumption.

Острый респираторный дистресс-синдром — одна из основных причин жизнеугрожающих осложнений и летальных исходов в педиатрических отделениях интенсивной терапии. Цель исследования — проанализировать современные особенности эпидемиологии, факторы риска и исходы острого респираторного диcтреcc-синдрома у детей старше одного месяца жизни по данным литературы. Поиск информации осуществляли с использованием ключевых слов: «острый респираторный дистресс-синдром», «дети», «эпидемиология», «respiratory distress syndrome», «pediatric», «control mechanical ventilation». В анализ включено 100 публикаций, входящих в реферативные базы данных eLibrary и PubMed. После первичного изучения абстрактов из обзора были исключены 64 статьи, содержащие уже ранее опубликованные сведения. В качестве основного источника взяты рекомендации Pediatric Acute Lung Injury Consensus Conference, которые были опубликованы в апреле 2023 г. Авторы обзора приводят актуальные дефиниции, факторы риска и критерии степени тяжести острого респираторного дистресс-синдрома в педиатрической практике, детально рассматривают особенности инвазивной вентиляции легких и адъювантной терапии, особое внимание уделяется инфузионной и трансфузионной терапии, питанию и седации. Один из разделов посвящен мониторингу состояния пациента, оценке эффективности газообмена и гемодинамики, подчеркивается важность динамической оценки наличия делирия у пациента и готовности его к экстубации. Рекомендации по лечению острого респираторного дистресса у детей Pediatric Acute Lung Injury Consensus Conference-2 позволяют более точно стратифицировать тяжесть течения патологического процесса, выявить пациентов группы риска с высокой вероятностью развития данного синдрома и начать своевременную протективную респираторную поддержку, направленную на восстановление паренхимы легких, оптимизацию доставки и потребления кислорода.

急性呼吸窘迫综合征是导致儿科重症监护室出现危及生命的并发症和死亡的主要原因之一。本研究旨在根据文献资料，对出生一个月以上儿童急性呼吸窘迫综合征的流行病学、风险因素和预后的现状进行分析。使用关键词“急性呼吸窘迫综合征”、“儿童”、“流行病学”、“呼吸窘迫综合征”、“儿科”、“控制性机械通气”搜索相关信息。分析共包括 eLibrary 和 PubMed 数据库中的 100 篇出版物。在对摘要进行初步审查后，64 篇包含先前已发表信息的文章被排除在审查范围之外。2023 年4月出版的《儿童急性肺损伤共识会议建议被作为主要资料来源。这篇综述的作者提供了儿科急性呼吸窘迫综合征的相关定义、风险因素和严重程度标准，并详细回顾了有创通气和辅助治疗的特点。特别关注输液和输血疗法、营养和镇静。其中一个章节的重点是关于监测患者的病情、评估气体交换效率和血液动力学，强调动态评估患者谵妄和拔管准备情况的重要性。小儿急性呼吸窘迫治疗建议《儿童急性肺损伤共识会议-2》，可以对病理过程的严重程度进行更准确的分层， 确定极有可能患上这种综合征的高危人群，并及时启动保护性呼吸支持，以恢复肺实质、优化氧气输送和消耗。

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