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Table 3 Comparison of pediatric recommendation to adult one

From: ARDS Clinical Practice Guideline 2021

CQ number

Question

Direction of recommendation

PCQ

Adult

 

Pediatric

Adult

1

14

Should non-invasive respiratory support (NPPV/HFNC) be used for pediatric patients with ARDS?

− 1

+1

2

19

Should tidal volume be restricted in pediatric patients with ARDS?

0

+2

3

20

Should high PEEP be used in pediatric patients with moderate to severe ARDS?

0

+1

4

21

Should plateau pressure be restricted in pediatric patients with ARDS?

0

+1

5

27

Should a protocol be used when liberating pediatric patients with acute respiratory failure from mechanical ventilator?

+1

+1

6

28

Should HFOV be used for pediatric patients with moderate to severe ARDS?

− 1

− 1

7

23

Should APRV be used for pediatric patients with ARDS?

− 1

0

8

30

How should target SpO2 values be set in pediatric patients with ARDS?(Adult: Is low SpO2 (PaO2) a target for management in adult patients with ARDS? )

0

− 1

9

31

Should muscle relaxants be used at an early stage in pediatric patients with moderate or severe ARDS?

0

+1

10

35

Should pediatric patients with moderate to severe ARDS be placed in the prone position?

+1

+1

11

40

Should nitric oxide inhalation therapy be used in pediatric patients with ARDS?

− 1

− 1

12

N/A

Should surfactant be used in pediatric patients with ARDS?

− 1

N/A

13

42

Should steroids be used in pediatric patients with ARDS?

0

high dose: − 1low dose: +2

14

N/A

Should a protocol be used for the sedation of pediatric respiratory failure patients?

+1

N/A

15

44

Should daily sedation interruption (DSI) be implemented for pediatric respiratory failure patients?(Adult: Should non-sedative or light-sedative management be conducted for adult patients with ARDS?)

− 1

+1

  1. +2, strong recommendation for using an intervention; +1, weak recommendation for using an intervention; 0, no recommendation; − 1, weak recommendation against using an intervention; N/A not applicable, CQ clinical question, PCQ pediatric clinical question