MEDLINE (Ovid), Embase (Elsevier), and CINAHL Complete (EBSCOhost).
Searches were limited to children, PARDS or hypoxic respiratory failure and overlap with pulmonary-specific ancillary therapies.
Title/abstract review, full-text review, and data extraction using a standardized data collection form.
The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize evidence and develop recommendations. Twenty-six studies were identified for full-text extraction. Four clinical recommendations were generated, related to use of inhaled nitric oxide, surfactant, prone positioning, and corticosteroids. Two good practice statements were generated on the use of routine endotracheal suctioning and installation of isotonic saline prior to endotracheal suctioning. Three research statements were generated related to: the use of open versus closed suctioning, specific methods of airway clearance, and various other ancillary therapies.
The evidence to support or refute any of the specific ancillary therapies in children with PARDS remains low. Further investigation, including a focus on specific subpopulations, is needed to better understand the role, if any, of these various ancillary therapies in PARDS.
方法:MEDLINE(Ovid),Embase(Elsevier),和CINAHL完成(EBSCOhost)。
方法:搜索仅限于儿童,PARDS或低氧性呼吸衰竭,并与肺部特异性辅助治疗重叠。
方法:标题/摘要评论,全文回顾,和使用标准化的数据收集表格进行数据提取。
结果:建议评估的分级,发展,采用评估方法进行证据识别和总结,并提出建议。确定了26项研究用于全文提取。产生了四项临床建议,与吸入一氧化氮的使用有关,表面活性剂,俯卧定位,和皮质类固醇。关于使用常规气管内抽吸和在气管内抽吸之前安装等渗盐水的两个良好实践声明。产生了三个研究陈述,涉及:使用开放式和封闭式抽吸,气道清除的具体方法,和其他各种辅助疗法。
结论:支持或反驳PARDS儿童任何特定辅助治疗的证据仍然很少。进一步调查,包括对特定亚群的关注,需要更好地理解角色,如果有的话,这些不同的辅助治疗PARDS。