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Physicians managing pediatric patients with acute lung injury or ARDS are faced with a complex array of options influencing oxygenation. Certain treatment strategies can influence clinical outcomes, such as a lung\u2010protective ventilation strategy that specifies a low tidal volume (6 mL\/kg) and a plateau pressure limit (30 cm H<jats:sub>2<\/jats:sub>O) (Acute Respiratory Distress Network, N Engl J Med <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#bib1\">2000<\/jats:ext-link>;342:1301\u20131308). Other lung\u2010protective strategies such as different levels of positive end\u2010expiratory pressure, altered inspiratory:expiratory ratios, recruitment maneuvers, prone positioning, and extraneous gases or drugs may impact clinical outcomes but require further clinical study.<\/jats:p><jats:p>This paper reviews state\u2010of\u2010the\u2010art strategies on the management of oxygenation in acute hypoxemic respiratory failure and attempts to guide pediatric pulmonologists in managing children with respiratory failure. Pediatr Pulmonol. 2001; 32:459\u2013470. \u00a9 2001 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ppul.1159","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T19:52:11Z","timestamp":1030305131000},"page":"459-470","source":"Crossref","is-referenced-by-count":15,"title":["Management of oxygenation in pediatric acute hypoxemic respiratory failure"],"prefix":"10.1002","volume":"32","author":[{"given":"Benjamin D.","family":"Matthews","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natan","family":"Noviski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2001,11,7]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005043421801"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00075198-199802000-00003"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199912000-00033"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.154.5.8912783"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.156.16.1797"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90697-1"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(67)90168-7"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.149.3.7509706"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005043421806"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.6.9808136"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.151.2.7842182"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.273.4.306"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199501053320106"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)81534-3"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)83039-2"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008480-199706000-00003"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199802053380602"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199422100-00011"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.1.54"},{"key":"e_1_2_1_21_2","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1152\/jappl.1994.77.3.1355","article-title":"Ventilator pattern influences neutrophil influx and activation in atelectasis\u2010prone rabbit lung","volume":"77","author":"Sugiura M","year":"1994","journal-title":"J Appl Physiol"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.149.5.8173774"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI119259"},{"key":"e_1_2_1_24_2","first-page":"485","article-title":"Causes of mortality in patients with the adult respiratory distress syndrome","volume":"132","author":"Montgomery AB","year":"1985","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_1_25_2","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1080\/21548331.1991.11704223","article-title":"Multiple system organ failure and the sepsis syndrome","volume":"26","author":"Bone RC","year":"1991","journal-title":"Hosp Pract [Off]"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.157.1.9604014"},{"key":"e_1_2_1_27_2","first-page":"556","article-title":"Experimental pulmonary edema due to intermittent positive pressure ventilation with high inflation pressures. 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