{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:59:19Z","timestamp":1793037559089,"version":"4.5.0"},"reference-count":130,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T00:00:00Z","timestamp":1728691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Acute respiratory failure (ARF) is a sudden failure of the respiratory system to ensure adequate gas exchanges. Numerous clinical conditions may cause ARF, including pneumonia, obstructive lung diseases (e.g., asthma), restrictive diseases such as neuromuscular diseases (e.g., spinal muscular atrophy and muscular dystrophy), and albeit rarely, interstitial lung diseases. Children, especially infants, may be more vulnerable to ARF than adults due to anatomical and physiological features of the respiratory system. Assessing respiratory impairment in the pediatric population is particularly challenging as children frequently present difficulties in reporting symptoms and due to compliance and cooperation in diagnostic tests. The evaluation of clinical and anamnestic aspects represents the cornerstone of ARF diagnosis: first level exams (e.g., arterial blood gas analysis) confirm and evaluate the severity of the ARF and second level exams help to uncover the underlying cause. Prompt management is critical, with supplemental oxygen, mechanical ventilation, and the treatment of the underlying problem. The aim of this review is to provide a comprehensive summary of the current state of the art in diagnosing pediatric ARF, with a focus on pathophysiology, novel imaging applications, and new perspectives, such as biomarkers and artificial intelligence.<\/jats:p>","DOI":"10.3390\/children11101232","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T04:02:58Z","timestamp":1728878578000},"page":"1232","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Acute Respiratory Failure in Children: A Clinical Update on Diagnosis"],"prefix":"10.3390","volume":"11","author":[{"given":"Beatrice","family":"Panetti","sequence":"first","affiliation":[{"name":"Pediatric Allergy and Pulmonology Unit, Department of Pediatrics, University of Chieti, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Bucci","sequence":"additional","affiliation":[{"name":"Pediatric Allergy and Pulmonology Unit, Department of Pediatrics, University of Chieti, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Di Ludovico","sequence":"additional","affiliation":[{"name":"Pediatric Allergy and Pulmonology Unit, Department of Pediatrics, University of Chieti, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia Michela","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7336-4292","authenticated-orcid":false,"given":"Paola","family":"Di Filippo","sequence":"additional","affiliation":[{"name":"Pediatric Allergy and Pulmonology Unit, Department of Pediatrics, University of Chieti, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Di Pillo","sequence":"additional","affiliation":[{"name":"Pediatric Allergy and Pulmonology Unit, Department of Pediatrics, University of Chieti, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Chiarelli","sequence":"additional","affiliation":[{"name":"Pediatric Allergy and Pulmonology Unit, Department of Pediatrics, University of Chieti, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6513-3160","authenticated-orcid":false,"given":"Marina","family":"Attanasi","sequence":"additional","affiliation":[{"name":"Pediatric Allergy and Pulmonology Unit, Department of Pediatrics, University of Chieti, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5245-4843","authenticated-orcid":false,"given":"Giuseppe Francesco","family":"Sferrazza Papa","sequence":"additional","affiliation":[{"name":"Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1001\/jamapediatrics.2023.0184","article-title":"Epidemiology of Intensive Care Admissions for Children in the US From 2001 to 2019","volume":"177","author":"Killien","year":"2023","journal-title":"JAMA Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e268","DOI":"10.3928\/19382359-20180625-01","article-title":"Acute Respiratory Failure in Children","volume":"47","author":"Friedman","year":"2018","journal-title":"Pediatr. 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