SCCM Resource Library-Where I Deviate From the PARDS Guidelines

Video Transcription

Video Summary

In this video, Dr. Alex Prota discusses areas where he deviates from the Pediatric Acute Respiratory Distress Syndrome (PARDS) guidelines. He specifically focuses on tidal volume, PEEP, high-frequency jet ventilation, and prone positioning. He explains that while the original PARDS guidelines recommended lower tidal volumes, he has deviated from this and ventilated patients with higher tidal volumes (around 9-10 mL/kg) as long as driving pressures are low. He also mentions the importance of driving pressure as a consideration. Regarding PEEP, he finds that many clinicians in reality deviate from the prescribed PEEP levels and this can have consequences on patient mortality. He discusses the use of high-frequency jet ventilation in patients under 8 kilograms who cannot be ventilated conventionally, but notes that the new guidelines do not address this. Finally, he talks about prone positioning and explains that while the original guidelines did not recommend it, he has found it helpful and the new guidelines now support the use of prone positioning in patients with severe PARDS and hypoxemia not responding to other interventions.

Asset Subtitle

Quality and Patient Safety, Pediatrics, Pulmonary, 2023

Asset Caption

Type: two-hour concurrent | New Pediatric ARDS Guidelines: Controversies and Next Steps (Pediatrics) (SessionID 1211606)

Meta Tag

Content Type Presentation

Knowledge Area Quality and Patient Safety

Knowledge Area Pediatrics

Knowledge Area Pulmonary

Membership Level Professional

Membership Level Select

Tag Guidelines

Tag Pediatrics

Tag Acute Respiratory Distress Syndrome ARDS

Year 2023

Keywords

Pediatric Acute Respiratory Distress Syndrome

tidal volume

PEEP

high-frequency jet ventilation

prone positioning

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