{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:53:27Z","timestamp":1747151607422,"version":"3.40.5"},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T00:00:00Z","timestamp":1657756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Low tidal volume and adequate positive end\u2010expiratory pressure (PEEP) are evidence\u2010based approaches for pediatric acute respiratory distress syndrome (pARDS), however, data are limited regarding their use since pARDS guidelines were revised in 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify prevalence of, and factors associated with, nonadherence to appropriate tidal volume and PEEP in children with pARDS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study of children 1 month to &lt;18 years with pARDS who received invasive mechanical ventilation from 2016 to 2018 in a single pediatric intensive care unit (PICU).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 24\u2009h after meeting pARDS criteria, 48\/86 (56%) patients received tidal volume \u22648\u2009ml\/kg of ideal body weight and 45\/86 (52%) received appropriate PEEP, with 22\/86 (26%) receiving both. Among patients \u22652 years of age, a lower proportion of patients with overweight\/obesity (9\/25, 36%) had appropriate tidal volume versus those in the normal or underweight category (16\/22, 73%, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). When FIO<jats:sub>2<\/jats:sub> was \u226550%, PEEP was appropriate in 19\/60 (32%) cases versus 26\/26 (100%) with FIO<jats:sub>2<\/jats:sub>\u2009&lt;\u200950% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). pARDS\u00a0was documented in the progress note in 7\/86 (8%) patients at 24\u2009h. Severity of pARDS, documentation in the progress note, and other clinical factors were not significantly associated with use of appropriate tidal volume and PEEP, however pARDS was documented more commonly in patients with severe pARDS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a single PICU in the United States, children with pARDS did not receive appropriate tidal volume for ideal body weight nor PEEP. Targets for improving tidal volume and PEEP adherence may include overweight patients and those receiving FIO<jats:sub>2<\/jats:sub>\u2009\u2265\u200950%, respectively.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26060","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T04:14:06Z","timestamp":1656735246000},"page":"2464-2473","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Nonadherence to appropriate tidal volume and PEEP in children with pARDS at a single center"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5880-750X","authenticated-orcid":false,"given":"Michael C.","family":"McCrory","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"},{"name":"Department of Pediatrics Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan G.","family":"Woodruff","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"},{"name":"Department of Pediatrics Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit K.","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joni K.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science Wake Forest School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth E.","family":"Halvorson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andora L.","family":"Bass","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"},{"name":"Department of Pediatrics Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,14]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_10_2_1","DOI":"10.1016\/S2213-2600(18)30344-8"},{"doi-asserted-by":"publisher","key":"e_1_2_10_3_1","DOI":"10.1097\/CCM.0000000000003341"},{"doi-asserted-by":"publisher","key":"e_1_2_10_4_1","DOI":"10.1097\/01.PCC.0000269408.64179.FF"},{"doi-asserted-by":"publisher","key":"e_1_2_10_5_1","DOI":"10.1164\/rccm.201707-1404OC"},{"doi-asserted-by":"publisher","key":"e_1_2_10_6_1","DOI":"10.1097\/CCM.0000000000005060"},{"doi-asserted-by":"publisher","key":"e_1_2_10_7_1","DOI":"10.1056\/NEJM200005043421801"},{"doi-asserted-by":"publisher","key":"e_1_2_10_8_1","DOI":"10.1164\/rccm.201409-1598OC"},{"doi-asserted-by":"publisher","key":"e_1_2_10_9_1","DOI":"10.1097\/01.CCM.0000198328.83571.4A"},{"doi-asserted-by":"publisher","key":"e_1_2_10_10_1","DOI":"10.1097\/01.CCM.0000127784.54727.56"},{"doi-asserted-by":"publisher","key":"e_1_2_10_11_1","DOI":"10.1097\/CCM.0b013e31816fc3d0"},{"issue":"11","key":"e_1_2_10_12_1","first-page":"1158","article-title":"Factors associated with adherence to low\u2010tidal volume strategy for acute lung injury and acute respiratory distress syndrome and their impacts on outcomes: an observational study and propensity analysis","volume":"80","author":"Chen YF","year":"2014","journal-title":"Minerva Anestesiol"},{"issue":"2","key":"e_1_2_10_13_1","first-page":"108","article-title":"Do we practise low tidal\u2010volume ventilation in the intensive care unit? A 14\u2010year audit","volume":"17","author":"Santamaria JD","year":"2015","journal-title":"Crit Care Resusc"},{"doi-asserted-by":"publisher","key":"e_1_2_10_14_1","DOI":"10.1007\/s00134-011-2367-1"},{"doi-asserted-by":"publisher","key":"e_1_2_10_15_1","DOI":"10.1097\/PCC.0000000000000903"},{"doi-asserted-by":"publisher","key":"e_1_2_10_16_1","DOI":"10.1097\/PCC.0000000000001319"},{"doi-asserted-by":"publisher","key":"e_1_2_10_17_1","DOI":"10.1186\/s13613-020-00687-3"},{"doi-asserted-by":"publisher","key":"e_1_2_10_18_1","DOI":"10.1097\/PCC.0000000000001331"},{"doi-asserted-by":"publisher","key":"e_1_2_10_19_1","DOI":"10.1097\/01.CCM.0000127266.39560.96"},{"doi-asserted-by":"publisher","key":"e_1_2_10_20_1","DOI":"10.1097\/01.CCM.0000287591.09487.70"},{"doi-asserted-by":"publisher","key":"e_1_2_10_21_1","DOI":"10.1097\/PCC.0000000000000350"},{"doi-asserted-by":"publisher","key":"e_1_2_10_22_1","DOI":"10.1097\/PCC.0b013e31829760cf"},{"doi-asserted-by":"publisher","key":"e_1_2_10_23_1","DOI":"10.1097\/00003246-199605000-00004"},{"doi-asserted-by":"publisher","key":"e_1_2_10_24_1","DOI":"10.1016\/S0140-6736(72)91324-4"},{"doi-asserted-by":"publisher","key":"e_1_2_10_25_1","DOI":"10.1097\/PCC.0000000000001740"},{"unstructured":"Centers for Disease Control and Prevention National Center for Health Statistics.Growth Charts. Available athttps:\/\/www.cdc.gov\/growthcharts\/index.htm. Accessed January 5th2022.","key":"e_1_2_10_26_1"},{"doi-asserted-by":"publisher","key":"e_1_2_10_27_1","DOI":"10.1177\/0115426507022002240"},{"issue":"246","key":"e_1_2_10_28_1","first-page":"1","article-title":"2000 CDC growth charts for the United States: methods and development","volume":"11","author":"Kuczmarski RJ","year":"2002","journal-title":"Vital Health Stat"},{"doi-asserted-by":"publisher","key":"e_1_2_10_29_1","DOI":"10.1161\/CIR.0b013e3182a5cfb3"},{"doi-asserted-by":"publisher","key":"e_1_2_10_30_1","DOI":"10.1016\/j.jpeds.2015.06.040"},{"doi-asserted-by":"publisher","key":"e_1_2_10_31_1","DOI":"10.1542\/hpeds.2017-0100"},{"doi-asserted-by":"publisher","key":"e_1_2_10_32_1","DOI":"10.1097\/PCC.0000000000001846"},{"doi-asserted-by":"publisher","key":"e_1_2_10_33_1","DOI":"10.1097\/PCC.0000000000001857"},{"doi-asserted-by":"publisher","key":"e_1_2_10_34_1","DOI":"10.1097\/CCM.0000000000000546"},{"doi-asserted-by":"publisher","key":"e_1_2_10_35_1","DOI":"10.1016\/S0031-3955(05)70339-4"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26060","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.26060","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26060","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T11:35:48Z","timestamp":1704972948000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.26060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,14]]},"references-count":34,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1002\/ppul.26060"],"URL":"https:\/\/doi.org\/10.1002\/ppul.26060","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"type":"print","value":"8755-6863"},{"type":"electronic","value":"1099-0496"}],"subject":[],"published":{"date-parts":[[2022,7,14]]},"assertion":[{"value":"2022-02-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}