The use of the Berlin definition for acute respiratory distress syndrome during infancy and early childhood: multicenter evaluation and expert consensus
Identifieur interne : 001816 ( Istex/Corpus ); précédent : 001815; suivant : 001817The use of the Berlin definition for acute respiratory distress syndrome during infancy and early childhood: multicenter evaluation and expert consensus
Auteurs : Daniele De Luca ; Marco Piastra ; Giovanna Chidini ; Pierre Tissieres ; Edoardo Calderini ; Sandrine Essouri ; Alberto Medina Villanueva ; Ana Vivanco Allende ; Marti Pons-Odena ; Luis Perez-Baena ; Michael Hermon ; Ascanio Tridente ; Giorgio Conti ; Massimo Antonelli ; Martin KneyberSource :
- Intensive Care Medicine [ 0342-4642 ] ; 2013.
Abstract
Abstract: Purpose: A new acute respiratory distress syndrome (ARDS) definition has been recently issued: the so-called Berlin definition (BD) has some characteristics that could make it suitable for pediatrics. The European Society for Pediatric Neonatal Intensive Care (ESPNIC) Respiratory Section started a project to evaluate BD validity in early childhood. A secondary aim was reaching a consensus on clinical tools (risk factors list and illustrative radiographs) to help the application of BD. Methods: This was an international, multicenter, retrospective study enrolling 221 children [aged greater than 30 days and less than 18 months; median age 6 (range 2–13) months], admitted to seven European pediatric intensive care units (PICU) with acute lung injury (ALI) or ARDS diagnosed with the earlier definition. Results: Patients were categorized according to the two definitions, as follows: ALI, 36; ARDS, 185 (for the American–European Consensus Conference (AECC) definition); mild, 36; moderate, 97; severe ARDS, 88 (for BD). Mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 25 % for severe ARDS, p = 0.04) and the composite outcome extracorporeal membrane oxygenation (ECMO)/mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 28.4 % for severe ARDS, p < 0.01) were different across the BD classes, whereas they were similar using the previous definition. Mortality [HR 2.7 (95 % CI 1.1–7.1)] and ECMO/mortality [HR 3 (95 % CI 1.1–7.9)] were increased only for the severe ARDS class and remained significant after adjustment for confounding factors. PICU stay was not different across severity classes, irrespective of the definition used. There was significant concordance between raters evaluating radiographs [ICC 0.6 (95 % CI 0.2–0.8)] and risk factors [ICC 0.92 (95 % CI 0.8–0.97)]. Conclusions: BD validity for children is similar to that already reported in adults and mainly due to the introduction of a “severe ARDS” category. We provided clinical tools to use BD for clinical practice, research, and health services planning in pediatric critical care.
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DOI: 10.1007/s00134-013-3110-x
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Italy</mods:affiliation></affiliation></author><author><name sortKey="Tissieres, Pierre" sort="Tissieres, Pierre" uniqKey="Tissieres P" first="Pierre" last="Tissieres">Pierre Tissieres</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, CHU Kremlin-Bicetre, South Paris University Teaching Hospitals, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Calderini, Edoardo" sort="Calderini, Edoardo" uniqKey="Calderini E" first="Edoardo" last="Calderini">Edoardo Calderini</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy</mods:affiliation></affiliation></author><author><name sortKey="Essouri, Sandrine" sort="Essouri, Sandrine" uniqKey="Essouri S" first="Sandrine" last="Essouri">Sandrine Essouri</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, CHU Kremlin-Bicetre, South Paris University Teaching 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Unit, Department of Pediatrics, Hospital Universitari Sant Joan de Déu, Barcelona, Spain</mods:affiliation></affiliation></author><author><name sortKey="Perez Baena, Luis" sort="Perez Baena, Luis" uniqKey="Perez Baena L" first="Luis" last="Perez-Baena">Luis Perez-Baena</name><affiliation><mods:affiliation>Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics, Hospital Universitari Sant Joan de Déu, Barcelona, Spain</mods:affiliation></affiliation></author><author><name sortKey="Hermon, Michael" sort="Hermon, Michael" uniqKey="Hermon M" first="Michael" last="Hermon">Michael Hermon</name><affiliation><mods:affiliation>Division of Neonatology, Intensive Care and Neuro-pediatrics, Medical University of Vienna, Vienna, Austria</mods:affiliation></affiliation></author><author><name sortKey="Tridente, Ascanio" sort="Tridente, Ascanio" uniqKey="Tridente A" first="Ascanio" last="Tridente">Ascanio Tridente</name><affiliation><mods:affiliation>Intensive Care Unit, Whiston Hospital, St. Helen’s and Knowsley Teaching Hospitals NHS Trust, UK and academic Unit of Medical Education, Sheffield Medical School, University of Sheffield, Sheffield, UK</mods:affiliation></affiliation></author><author><name sortKey="Conti, Giorgio" sort="Conti, Giorgio" uniqKey="Conti G" first="Giorgio" last="Conti">Giorgio Conti</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Antonelli, Massimo" sort="Antonelli, Massimo" uniqKey="Antonelli M" first="Massimo" last="Antonelli">Massimo Antonelli</name><affiliation><mods:affiliation>General Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Kneyber, Martin" sort="Kneyber, Martin" uniqKey="Kneyber M" first="Martin" last="Kneyber">Martin Kneyber</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:0879E74D661E8A1B93A6DEB58D4004188719E455</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1007/s00134-013-3110-x</idno><idno type="url">https://api.istex.fr/ark:/67375/VQC-6M0WKS1C-V/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">001816</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001816</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">The use of the Berlin definition for acute respiratory distress syndrome during infancy and early childhood: multicenter evaluation and expert consensus</title><author><name sortKey="De Luca, Daniele" sort="De Luca, Daniele" uniqKey="De Luca D" first="Daniele" last="De Luca">Daniele De Luca</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Neonatal Intensive Care Unit, CHU Antoine Béclère, South Paris University Teaching Hospitals, Paris, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Terapia Intensiva Pediatrica–DEA, Policlinico Universitario “A. Gemelli”–Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: daniele.deluca@rm.unicatt.it</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: dm.deluca@fastwebnet.it</mods:affiliation></affiliation></author><author><name sortKey="Piastra, Marco" sort="Piastra, Marco" uniqKey="Piastra M" first="Marco" last="Piastra">Marco Piastra</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Chidini, Giovanna" sort="Chidini, Giovanna" uniqKey="Chidini G" first="Giovanna" last="Chidini">Giovanna Chidini</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy</mods:affiliation></affiliation></author><author><name sortKey="Tissieres, Pierre" sort="Tissieres, Pierre" uniqKey="Tissieres P" first="Pierre" last="Tissieres">Pierre Tissieres</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, CHU Kremlin-Bicetre, South Paris University Teaching Hospitals, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Calderini, Edoardo" sort="Calderini, Edoardo" uniqKey="Calderini E" first="Edoardo" last="Calderini">Edoardo Calderini</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy</mods:affiliation></affiliation></author><author><name sortKey="Essouri, Sandrine" sort="Essouri, Sandrine" uniqKey="Essouri S" first="Sandrine" last="Essouri">Sandrine Essouri</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, CHU Kremlin-Bicetre, South Paris University Teaching Hospitals, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Medina Villanueva, Alberto" sort="Medina Villanueva, Alberto" uniqKey="Medina Villanueva A" first="Alberto" last="Medina Villanueva">Alberto Medina Villanueva</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario de Asturias, Oviedo, Spain</mods:affiliation></affiliation></author><author><name sortKey="Vivanco Allende, Ana" sort="Vivanco Allende, Ana" uniqKey="Vivanco Allende A" first="Ana" last="Vivanco Allende">Ana Vivanco Allende</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario de Asturias, Oviedo, Spain</mods:affiliation></affiliation></author><author><name sortKey="Pons Odena, Marti" sort="Pons Odena, Marti" uniqKey="Pons Odena M" first="Marti" last="Pons-Odena">Marti Pons-Odena</name><affiliation><mods:affiliation>Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics, Hospital Universitari Sant Joan de Déu, Barcelona, Spain</mods:affiliation></affiliation></author><author><name sortKey="Perez Baena, Luis" sort="Perez Baena, Luis" uniqKey="Perez Baena L" first="Luis" last="Perez-Baena">Luis Perez-Baena</name><affiliation><mods:affiliation>Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics, Hospital Universitari Sant Joan de Déu, Barcelona, Spain</mods:affiliation></affiliation></author><author><name sortKey="Hermon, Michael" sort="Hermon, Michael" uniqKey="Hermon M" first="Michael" last="Hermon">Michael Hermon</name><affiliation><mods:affiliation>Division of Neonatology, Intensive Care and Neuro-pediatrics, Medical University of Vienna, Vienna, Austria</mods:affiliation></affiliation></author><author><name sortKey="Tridente, Ascanio" sort="Tridente, Ascanio" uniqKey="Tridente A" first="Ascanio" last="Tridente">Ascanio Tridente</name><affiliation><mods:affiliation>Intensive Care Unit, Whiston Hospital, St. Helen’s and Knowsley Teaching Hospitals NHS Trust, UK and academic Unit of Medical Education, Sheffield Medical School, University of Sheffield, Sheffield, UK</mods:affiliation></affiliation></author><author><name sortKey="Conti, Giorgio" sort="Conti, Giorgio" uniqKey="Conti G" first="Giorgio" last="Conti">Giorgio Conti</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Antonelli, Massimo" sort="Antonelli, Massimo" uniqKey="Antonelli M" first="Massimo" last="Antonelli">Massimo Antonelli</name><affiliation><mods:affiliation>General Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Kneyber, Martin" sort="Kneyber, Martin" uniqKey="Kneyber M" first="Martin" last="Kneyber">Martin Kneyber</name><affiliation><mods:affiliation>Pediatric Intensive Care Unit, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Intensive Care Medicine</title><title level="j" type="abbrev">Intensive Care Med</title><idno type="ISSN">0342-4642</idno><idno type="eISSN">1432-1238</idno><imprint><publisher ref="https://scientific-publisher.data.istex.fr/ark:/67375/H02-SWLMH5L1-1">Springer Berlin Heidelberg</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="2013">2013</date><biblScope unit="vol" from="39" to="39">39</biblScope><biblScope unit="issue" from="12" to="12">12</biblScope><biblScope unit="page" from="2083">2083</biblScope><biblScope unit="page" to="2091">2091</biblScope></imprint><idno type="ISSN">0342-4642</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0342-4642</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Purpose: A new acute respiratory distress syndrome (ARDS) definition has been recently issued: the so-called Berlin definition (BD) has some characteristics that could make it suitable for pediatrics. The European Society for Pediatric Neonatal Intensive Care (ESPNIC) Respiratory Section started a project to evaluate BD validity in early childhood. A secondary aim was reaching a consensus on clinical tools (risk factors list and illustrative radiographs) to help the application of BD. Methods: This was an international, multicenter, retrospective study enrolling 221 children [aged greater than 30 days and less than 18 months; median age 6 (range 2–13) months], admitted to seven European pediatric intensive care units (PICU) with acute lung injury (ALI) or ARDS diagnosed with the earlier definition. Results: Patients were categorized according to the two definitions, as follows: ALI, 36; ARDS, 185 (for the American–European Consensus Conference (AECC) definition); mild, 36; moderate, 97; severe ARDS, 88 (for BD). Mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 25 % for severe ARDS, p = 0.04) and the composite outcome extracorporeal membrane oxygenation (ECMO)/mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 28.4 % for severe ARDS, p < 0.01) were different across the BD classes, whereas they were similar using the previous definition. Mortality [HR 2.7 (95 % CI 1.1–7.1)] and ECMO/mortality [HR 3 (95 % CI 1.1–7.9)] were increased only for the severe ARDS class and remained significant after adjustment for confounding factors. PICU stay was not different across severity classes, irrespective of the definition used. There was significant concordance between raters evaluating radiographs [ICC 0.6 (95 % CI 0.2–0.8)] and risk factors [ICC 0.92 (95 % CI 0.8–0.97)]. Conclusions: BD validity for children is similar to that already reported in adults and mainly due to the introduction of a “severe ARDS” category. We provided clinical tools to use BD for clinical practice, research, and health services planning in pediatric critical care.</div></front></TEI><istex><corpusName>springer-journals</corpusName><author><json:item><name>Daniele De Luca</name><affiliations><json:string>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</json:string><json:string>Neonatal Intensive Care Unit, CHU Antoine Béclère, South Paris University Teaching Hospitals, Paris, France</json:string><json:string>Terapia Intensiva Pediatrica–DEA, Policlinico Universitario “A. Gemelli”–Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy</json:string><json:string>E-mail: daniele.deluca@rm.unicatt.it</json:string><json:string>E-mail: dm.deluca@fastwebnet.it</json:string></affiliations></json:item><json:item><name>Marco Piastra</name><affiliations><json:string>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</json:string></affiliations></json:item><json:item><name>Giovanna Chidini</name><affiliations><json:string>Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy</json:string></affiliations></json:item><json:item><name>Pierre Tissieres</name><affiliations><json:string>Pediatric Intensive Care Unit, CHU Kremlin-Bicetre, South Paris University Teaching Hospitals, Paris, France</json:string></affiliations></json:item><json:item><name>Edoardo Calderini</name><affiliations><json:string>Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy</json:string></affiliations></json:item><json:item><name>Sandrine Essouri</name><affiliations><json:string>Pediatric Intensive Care Unit, CHU Kremlin-Bicetre, South Paris University Teaching Hospitals, Paris, France</json:string></affiliations></json:item><json:item><name>Alberto Medina Villanueva</name><affiliations><json:string>Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario de Asturias, Oviedo, Spain</json:string></affiliations></json:item><json:item><name>Ana Vivanco Allende</name><affiliations><json:string>Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario de Asturias, Oviedo, Spain</json:string></affiliations></json:item><json:item><name>Marti Pons-Odena</name><affiliations><json:string>Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics, Hospital Universitari Sant Joan de Déu, Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Luis Perez-Baena</name><affiliations><json:string>Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics, Hospital Universitari Sant Joan de Déu, Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Michael Hermon</name><affiliations><json:string>Division of Neonatology, Intensive Care and Neuro-pediatrics, Medical University of Vienna, Vienna, Austria</json:string></affiliations></json:item><json:item><name>Ascanio Tridente</name><affiliations><json:string>Intensive Care Unit, Whiston Hospital, St. Helen’s and Knowsley Teaching Hospitals NHS Trust, UK and academic Unit of Medical Education, Sheffield Medical School, University of Sheffield, Sheffield, UK</json:string></affiliations></json:item><json:item><name>Giorgio Conti</name><affiliations><json:string>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</json:string></affiliations></json:item><json:item><name>Massimo Antonelli</name><affiliations><json:string>General Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</json:string></affiliations></json:item><json:item><name>Martin Kneyber</name><affiliations><json:string>Pediatric Intensive Care Unit, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>ARDS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Children</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Diagnostic criteria</value></json:item></subject><articleId><json:string>3110</json:string><json:string>s00134-013-3110-x</json:string></articleId><arkIstex>ark:/67375/VQC-6M0WKS1C-V</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>OriginalPaper</json:string></originalGenre><abstract>Abstract: Purpose: A new acute respiratory distress syndrome (ARDS) definition has been recently issued: the so-called Berlin definition (BD) has some characteristics that could make it suitable for pediatrics. The European Society for Pediatric Neonatal Intensive Care (ESPNIC) Respiratory Section started a project to evaluate BD validity in early childhood. A secondary aim was reaching a consensus on clinical tools (risk factors list and illustrative radiographs) to help the application of BD. Methods: This was an international, multicenter, retrospective study enrolling 221 children [aged greater than 30 days and less than 18 months; median age 6 (range 2–13) months], admitted to seven European pediatric intensive care units (PICU) with acute lung injury (ALI) or ARDS diagnosed with the earlier definition. Results: Patients were categorized according to the two definitions, as follows: ALI, 36; ARDS, 185 (for the American–European Consensus Conference (AECC) definition); mild, 36; moderate, 97; severe ARDS, 88 (for BD). Mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 25 % for severe ARDS, p = 0.04) and the composite outcome extracorporeal membrane oxygenation (ECMO)/mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 28.4 % for severe ARDS, p > 0.01) were different across the BD classes, whereas they were similar using the previous definition. Mortality [HR 2.7 (95 % CI 1.1–7.1)] and ECMO/mortality [HR 3 (95 % CI 1.1–7.9)] were increased only for the severe ARDS class and remained significant after adjustment for confounding factors. PICU stay was not different across severity classes, irrespective of the definition used. There was significant concordance between raters evaluating radiographs [ICC 0.6 (95 % CI 0.2–0.8)] and risk factors [ICC 0.92 (95 % CI 0.8–0.97)]. Conclusions: BD validity for children is similar to that already reported in adults and mainly due to the introduction of a “severe ARDS” category. We provided clinical tools to use BD for clinical practice, research, and health services planning in pediatric critical care.</abstract><qualityIndicators><score>8.667</score><pdfWordCount>5089</pdfWordCount><pdfCharCount>33330</pdfCharCount><pdfVersion>1.4</pdfVersion><pdfPageCount>9</pdfPageCount><pdfPageSize>595.276 x 790.866 pts</pdfPageSize><refBibsNative>false</refBibsNative><abstractWordCount>320</abstractWordCount><abstractCharCount>2092</abstractCharCount><keywordCount>3</keywordCount><pdfWordsPerPage>565</pdfWordsPerPage><pdfText>true</pdfText></qualityIndicators><title>The use of the Berlin definition for acute respiratory distress syndrome during infancy and early childhood: multicenter evaluation and expert consensus</title><corporate><json:item><name>On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</name><affiliations><json:string>1-3 Rue de Chantepoulet, P.O. 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Gemelli”–Università Cattolica del Sacro Cuore</orgName><address><street>L.go A. Gemelli 8</street><postCode>00168</postCode><settlement>Rome</settlement><country key="IT" xml:lang="en">ITALY</country></address></affiliation></author><author><persName><forename type="first">Marco</forename><surname>Piastra</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care</orgName><orgName type="institution">University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart</orgName><address><settlement>Rome</settlement><country key="IT" xml:lang="en">ITALY</country></address></affiliation></author><author><persName><forename type="first">Giovanna</forename><surname>Chidini</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care</orgName><orgName type="institution">Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico</orgName><address><settlement>Milan</settlement><country key="IT" xml:lang="en">ITALY</country></address></affiliation></author><author><persName><forename type="first">Pierre</forename><surname>Tissieres</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care Unit, CHU Kremlin-Bicetre</orgName><orgName type="institution">South Paris University Teaching Hospitals</orgName><address><settlement>Paris</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">Edoardo</forename><surname>Calderini</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care</orgName><orgName type="institution">Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico</orgName><address><settlement>Milan</settlement><country key="IT" xml:lang="en">ITALY</country></address></affiliation></author><author><persName><forename type="first">Sandrine</forename><surname>Essouri</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care Unit, CHU Kremlin-Bicetre</orgName><orgName type="institution">South Paris University Teaching Hospitals</orgName><address><settlement>Paris</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">Alberto</forename><surname>Medina Villanueva</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care Unit, Department of Pediatrics</orgName><orgName type="institution">Hospital Universitario de Asturias</orgName><address><settlement>Oviedo</settlement><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><author><persName><forename type="first">Ana</forename><surname>Vivanco Allende</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care Unit, Department of Pediatrics</orgName><orgName type="institution">Hospital Universitario de Asturias</orgName><address><settlement>Oviedo</settlement><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><author><persName><forename type="first">Marti</forename><surname>Pons-Odena</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics</orgName><orgName type="institution">Hospital Universitari Sant Joan de Déu</orgName><address><settlement>Barcelona</settlement><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><author><persName><forename type="first">Luis</forename><surname>Perez-Baena</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics</orgName><orgName type="institution">Hospital Universitari Sant Joan de Déu</orgName><address><settlement>Barcelona</settlement><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><author><persName><forename type="first">Michael</forename><surname>Hermon</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Division of Neonatology, Intensive Care and Neuro-pediatrics</orgName><orgName type="institution">Medical University of Vienna</orgName><address><settlement>Vienna</settlement><country key="AT" xml:lang="en">AUSTRIA</country></address></affiliation></author><author><persName><forename type="first">Ascanio</forename><surname>Tridente</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Intensive Care Unit, Whiston Hospital, St. Helen’s and Knowsley Teaching Hospitals NHS Trust</orgName><orgName type="institution">UK and academic Unit of Medical Education, Sheffield Medical School, University of Sheffield</orgName><address><settlement>Sheffield</settlement><country key="GB" xml:lang="en">UNITED KINGDOM</country></address></affiliation></author><author><persName><forename type="first">Giorgio</forename><surname>Conti</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care</orgName><orgName type="institution">University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart</orgName><address><settlement>Rome</settlement><country key="IT" xml:lang="en">ITALY</country></address></affiliation></author><author><persName><forename type="first">Massimo</forename><surname>Antonelli</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">General Intensive Care Unit, Department of Anesthesia and Intensive Care</orgName><orgName type="institution">University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart</orgName><address><settlement>Rome</settlement><country key="IT" xml:lang="en">ITALY</country></address></affiliation></author><author><persName><forename type="first">Martin</forename><surname>Kneyber</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><orgName type="department">Pediatric Intensive Care Unit, Department of Pediatrics</orgName><orgName type="institution">Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen</orgName><address><settlement>Groningen</settlement><country key="NL" xml:lang="en">THE NETHERLANDS</country></address></affiliation></author><author><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><persName><surname>On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</surname></persName><affiliation><orgName type="institution">On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</orgName><address><street>1-3 Rue de Chantepoulet</street><postBox>P.O. Box 1726</postBox><postCode>1211</postCode><settlement>Geneva 1</settlement><country key="CH" xml:lang="en">SWITZERLAND</country></address></affiliation></author><idno type="istex">0879E74D661E8A1B93A6DEB58D4004188719E455</idno><idno type="ark">ark:/67375/VQC-6M0WKS1C-V</idno><idno type="publisher-id">s00134-013-3110-x</idno><idno type="DOI">10.1007/s00134-013-3110-x</idno><idno type="article-id">3110</idno></analytic><monogr><title level="j" type="main">Intensive Care Medicine</title><title level="j" type="abbrev">Intensive Care Med</title><idno type="journal-id">134</idno><idno type="pISSN">0342-4642</idno><idno type="eISSN">1432-1238</idno><imprint><publisher ref="https://scientific-publisher.data.istex.fr/ark:/67375/H02-SWLMH5L1-1">Springer Berlin Heidelberg</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="2013">2013</date><biblScope unit="vol" from="39" to="39">39</biblScope><biblScope unit="issue" from="12" to="12">12</biblScope><biblScope unit="page" from="2083">2083</biblScope><biblScope unit="page" to="2091">2091</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><encodingDesc><schemaRef type="ODD" url="https://xml-schema.delivery.istex.fr/tei-istex.odd"></schemaRef><appInfo><application ident="pub2tei" version="1.0.48" when="2020-05-28"><label>pub2TEI-ISTEX</label><desc>A set of style sheets for converting XML documents encoded in various scientific publisher formats into a common TEI format.
<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en"><head>Abstract</head><head>Purpose</head><p>A new acute respiratory distress syndrome (ARDS) definition has been recently issued: the so-called Berlin definition (BD) has some characteristics that could make it suitable for pediatrics. The European Society for Pediatric Neonatal Intensive Care (ESPNIC) Respiratory Section started a project to evaluate BD validity in early childhood. A secondary aim was reaching a consensus on clinical tools (risk factors list and illustrative radiographs) to help the application of BD.</p><head>Methods</head><p>This was an international, multicenter, retrospective study enrolling 221 children [aged greater than 30 days and less than 18 months; median age 6 (range 2–13) months], admitted to seven European pediatric intensive care units (PICU) with acute lung injury (ALI) or ARDS diagnosed with the earlier definition.</p><head>Results</head><p>Patients were categorized according to the two definitions, as follows: ALI, 36; ARDS, 185 (for the American–European Consensus Conference (AECC) definition); mild, 36; moderate, 97; severe ARDS, 88 (for BD). Mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 25 % for severe ARDS, <hi rend="italic">p</hi> = 0.04) and the composite outcome extracorporeal membrane oxygenation (ECMO)/mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 28.4 % for severe ARDS, <hi rend="italic">p</hi> < 0.01) were different across the BD classes, whereas they were similar using the previous definition. Mortality [HR 2.7 (95 % CI 1.1–7.1)] and ECMO/mortality [HR 3 (95 % CI 1.1–7.9)] were increased only for the severe ARDS class and remained significant after adjustment for confounding factors. PICU stay was not different across severity classes, irrespective of the definition used. There was significant concordance between raters evaluating radiographs [ICC 0.6 (95 % CI 0.2–0.8)] and risk factors [ICC 0.92 (95 % CI 0.8–0.97)].</p><head>Conclusions</head><p>BD validity for children is similar to that already reported in adults and mainly due to the introduction of a “severe ARDS” category. We provided clinical tools to use BD for clinical practice, research, and health services planning in pediatric critical care.</p></abstract><textClass ana="subject"><keywords scheme="journal-subject"><list><item><label>SCH</label><term type="Primary">Medicine & Public Health</term></item><item><label>SCH3100X</label><term type="Secondary" subtype="priority-1">Intensive / Critical Care Medicine</term></item><item><label>SCH13001</label><term type="Secondary" subtype="priority-2">Anesthesiology</term></item><item><label>SCH22000</label><term type="Secondary" subtype="priority-3">Emergency Medicine</term></item><item><label>SCH33134</label><term type="Secondary" subtype="priority-4">Pneumology/Respiratory System</term></item><item><label>SCH47003</label><term type="Secondary" subtype="priority-5">Pain Medicine</term></item><item><label>SCH49006</label><term type="Secondary" subtype="priority-6">Pediatrics</term></item></list></keywords></textClass><textClass ana="keyword"><keywords xml:lang="en"><term>ARDS</term><term>Children</term><term>Diagnostic criteria</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2020-05-28" who="#istex" xml:id="pub2tei">formatting</change><change when="2013-09-07">Registration</change><change when="2013-05-27">Received</change><change when="2013-09-07">Accepted</change><change when="2013-10-08">ePublished</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-6M0WKS1C-V/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus springer-journals not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//Springer-Verlag//DTD A++ V2.4//EN" URI="http://devel.springer.de/A++/V2.4/DTD/A++V2.4.dtd" name="istex:docType"></istex:docType><istex:document><Publisher><PublisherInfo><PublisherName>Springer Berlin Heidelberg</PublisherName><PublisherLocation>Berlin/Heidelberg</PublisherLocation><PublisherImprintName>Springer</PublisherImprintName></PublisherInfo><Journal OutputMedium="All"><JournalInfo JournalProductType="NonStandardArchiveJournal" NumberingStyle="Unnumbered"><JournalID>134</JournalID><JournalDOI>10.1007/134.1432-1238</JournalDOI><JournalPrintISSN>0342-4642</JournalPrintISSN><JournalElectronicISSN>1432-1238</JournalElectronicISSN><JournalTitle>Intensive Care Medicine</JournalTitle><JournalAbbreviatedTitle>Intensive Care Med</JournalAbbreviatedTitle><JournalSubjectGroup><JournalSubject Code="SCH" Type="Primary">Medicine & Public Health</JournalSubject><JournalSubject Code="SCH3100X" Priority="1" Type="Secondary">Intensive / Critical Care Medicine</JournalSubject><JournalSubject Code="SCH13001" Priority="2" Type="Secondary">Anesthesiology</JournalSubject><JournalSubject Code="SCH22000" Priority="3" Type="Secondary">Emergency Medicine</JournalSubject><JournalSubject Code="SCH33134" Priority="4" Type="Secondary">Pneumology/Respiratory System</JournalSubject><JournalSubject Code="SCH47003" Priority="5" Type="Secondary">Pain Medicine</JournalSubject><JournalSubject Code="SCH49006" Priority="6" Type="Secondary">Pediatrics</JournalSubject><SubjectCollection Code="SC11">Medicine</SubjectCollection></JournalSubjectGroup></JournalInfo><Volume OutputMedium="All"><VolumeInfo TocLevels="0" VolumeType="Regular"><VolumeIDStart>39</VolumeIDStart><VolumeIDEnd>39</VolumeIDEnd><VolumeIssueCount>12</VolumeIssueCount></VolumeInfo><Issue IssueType="Regular" OutputMedium="All"><IssueInfo IssueType="Regular" TocLevels="0"><IssueIDStart>12</IssueIDStart><IssueIDEnd>12</IssueIDEnd><IssueArticleCount>34</IssueArticleCount><IssueHistory><OnlineDate><Year>2013</Year><Month>11</Month><Day>7</Day></OnlineDate><PrintDate><Year>2013</Year><Month>11</Month><Day>6</Day></PrintDate><CoverDate><Year>2013</Year><Month>12</Month></CoverDate><PricelistYear>2013</PricelistYear></IssueHistory><IssueCopyright><CopyrightHolderName>Springer-Verlag Berlin Heidelberg and ESICM</CopyrightHolderName><CopyrightYear>2013</CopyrightYear></IssueCopyright></IssueInfo><Article ID="s00134-013-3110-x" OutputMedium="All"><ArticleInfo ArticleType="OriginalPaper" ContainsESM="Yes" Language="En" NumberingStyle="Unnumbered" TocLevels="0"><ArticleID>3110</ArticleID><ArticleDOI>10.1007/s00134-013-3110-x</ArticleDOI><ArticleSequenceNumber>3</ArticleSequenceNumber><ArticleTitle Language="En" OutputMedium="All">The use of the Berlin definition for acute respiratory distress syndrome during infancy and early childhood: multicenter evaluation and expert consensus</ArticleTitle><ArticleCategory>Seven-Day Profile Publication</ArticleCategory><ArticleFirstPage>2083</ArticleFirstPage><ArticleLastPage>2091</ArticleLastPage><ArticleHistory><RegistrationDate><Year>2013</Year><Month>9</Month><Day>7</Day></RegistrationDate><Received><Year>2013</Year><Month>5</Month><Day>27</Day></Received><Accepted><Year>2013</Year><Month>9</Month><Day>7</Day></Accepted><OnlineDate><Year>2013</Year><Month>10</Month><Day>8</Day></OnlineDate></ArticleHistory><ArticleCopyright><CopyrightHolderName>Springer-Verlag Berlin Heidelberg and ESICM</CopyrightHolderName><CopyrightYear>2013</CopyrightYear></ArticleCopyright><ArticleGrants Type="Regular"><MetadataGrant Grant="OpenAccess"></MetadataGrant><AbstractGrant Grant="OpenAccess"></AbstractGrant><BodyPDFGrant Grant="OpenAccess"></BodyPDFGrant><BodyHTMLGrant Grant="OpenAccess"></BodyHTMLGrant><BibliographyGrant Grant="OpenAccess"></BibliographyGrant><ESMGrant Grant="OpenAccess"></ESMGrant></ArticleGrants></ArticleInfo><ArticleHeader><AuthorGroup><Author AffiliationIDS="Aff1 Aff2 Aff11" CorrespondingAffiliationID="Aff11"><AuthorName DisplayOrder="Western"><GivenName>Daniele</GivenName><Particle>De</Particle><FamilyName>Luca</FamilyName></AuthorName><Contact><Phone>+39-6-30155203</Phone><Fax>+39-6-30155283</Fax><Email>daniele.deluca@rm.unicatt.it</Email><Email>dm.deluca@fastwebnet.it</Email></Contact></Author><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Marco</GivenName><FamilyName>Piastra</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff3"><AuthorName DisplayOrder="Western"><GivenName>Giovanna</GivenName><FamilyName>Chidini</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff4"><AuthorName DisplayOrder="Western"><GivenName>Pierre</GivenName><FamilyName>Tissieres</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff3"><AuthorName DisplayOrder="Western"><GivenName>Edoardo</GivenName><FamilyName>Calderini</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff4"><AuthorName DisplayOrder="Western"><GivenName>Sandrine</GivenName><FamilyName>Essouri</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff5"><AuthorName DisplayOrder="Western"><GivenName>Alberto</GivenName><FamilyName>Medina Villanueva</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff5"><AuthorName DisplayOrder="Western"><GivenName>Ana</GivenName><FamilyName>Vivanco Allende</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff6"><AuthorName DisplayOrder="Western"><GivenName>Marti</GivenName><FamilyName>Pons-Odena</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff6"><AuthorName DisplayOrder="Western"><GivenName>Luis</GivenName><FamilyName>Perez-Baena</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff7"><AuthorName DisplayOrder="Western"><GivenName>Michael</GivenName><FamilyName>Hermon</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff8"><AuthorName DisplayOrder="Western"><GivenName>Ascanio</GivenName><FamilyName>Tridente</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Giorgio</GivenName><FamilyName>Conti</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff9"><AuthorName DisplayOrder="Western"><GivenName>Massimo</GivenName><FamilyName>Antonelli</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff10"><AuthorName DisplayOrder="Western"><GivenName>Martin</GivenName><FamilyName>Kneyber</FamilyName></AuthorName></Author><InstitutionalAuthor AffiliationIDS="Aff12"><InstitutionalAuthorName>On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</InstitutionalAuthorName></InstitutionalAuthor><Affiliation ID="Aff11"><OrgDivision>Terapia Intensiva Pediatrica–DEA</OrgDivision><OrgName>Policlinico Universitario “A. Gemelli”–Università Cattolica del Sacro Cuore</OrgName><OrgAddress><Street>L.go A. Gemelli 8</Street><Postcode>00168</Postcode><City>Rome</City><Country Code="IT">Italy</Country></OrgAddress></Affiliation><Affiliation ID="Aff2"><OrgDivision>Neonatal Intensive Care Unit, CHU Antoine Béclère</OrgDivision><OrgName>South Paris University Teaching Hospitals</OrgName><OrgAddress><City>Paris</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff3"><OrgDivision>Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care</OrgDivision><OrgName>Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico</OrgName><OrgAddress><City>Milan</City><Country Code="IT">Italy</Country></OrgAddress></Affiliation><Affiliation ID="Aff4"><OrgDivision>Pediatric Intensive Care Unit, CHU Kremlin-Bicetre</OrgDivision><OrgName>South Paris University Teaching Hospitals</OrgName><OrgAddress><City>Paris</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff5"><OrgDivision>Pediatric Intensive Care Unit, Department of Pediatrics</OrgDivision><OrgName>Hospital Universitario de Asturias</OrgName><OrgAddress><City>Oviedo</City><Country Code="ES">Spain</Country></OrgAddress></Affiliation><Affiliation ID="Aff6"><OrgDivision>Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics</OrgDivision><OrgName>Hospital Universitari Sant Joan de Déu</OrgName><OrgAddress><City>Barcelona</City><Country Code="ES">Spain</Country></OrgAddress></Affiliation><Affiliation ID="Aff7"><OrgDivision>Division of Neonatology, Intensive Care and Neuro-pediatrics</OrgDivision><OrgName>Medical University of Vienna</OrgName><OrgAddress><City>Vienna</City><Country Code="AT">Austria</Country></OrgAddress></Affiliation><Affiliation ID="Aff8"><OrgDivision>Intensive Care Unit, Whiston Hospital, St. Helen’s and Knowsley Teaching Hospitals NHS Trust</OrgDivision><OrgName>UK and academic Unit of Medical Education, Sheffield Medical School, University of Sheffield</OrgName><OrgAddress><City>Sheffield</City><Country Code="GB">UK</Country></OrgAddress></Affiliation><Affiliation ID="Aff9"><OrgDivision>General Intensive Care Unit, Department of Anesthesia and Intensive Care</OrgDivision><OrgName>University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart</OrgName><OrgAddress><City>Rome</City><Country Code="IT">Italy</Country></OrgAddress></Affiliation><Affiliation ID="Aff10"><OrgDivision>Pediatric Intensive Care Unit, Department of Pediatrics</OrgDivision><OrgName>Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen</OrgName><OrgAddress><City>Groningen</City><Country Code="NL">The Netherlands</Country></OrgAddress></Affiliation><Affiliation ID="Aff1"><OrgDivision>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care</OrgDivision><OrgName>University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart</OrgName><OrgAddress><City>Rome</City><Country Code="IT">Italy</Country></OrgAddress></Affiliation><Affiliation ID="Aff12"><OrgAddress><Street>1-3 Rue de Chantepoulet</Street><Postbox>P.O. Box 1726</Postbox><Postcode>1211</Postcode><City>Geneva 1</City><Country Code="CH">Switzerland</Country></OrgAddress></Affiliation></AuthorGroup><Abstract ID="Abs1" Language="En" OutputMedium="All"><Heading>Abstract</Heading><AbstractSection ID="ASec1"><Heading>Purpose</Heading><Para>A new acute respiratory distress syndrome (ARDS) definition has been recently issued: the so-called Berlin definition (BD) has some characteristics that could make it suitable for pediatrics. The European Society for Pediatric Neonatal Intensive Care (ESPNIC) Respiratory Section started a project to evaluate BD validity in early childhood. A secondary aim was reaching a consensus on clinical tools (risk factors list and illustrative radiographs) to help the application of BD.</Para></AbstractSection><AbstractSection ID="ASec2"><Heading>Methods</Heading><Para>This was an international, multicenter, retrospective study enrolling 221 children [aged greater than 30 days and less than 18 months; median age 6 (range 2–13) months], admitted to seven European pediatric intensive care units (PICU) with acute lung injury (ALI) or ARDS diagnosed with the earlier definition.</Para></AbstractSection><AbstractSection ID="ASec3"><Heading>Results</Heading><Para>Patients were categorized according to the two definitions, as follows: ALI, 36; ARDS, 185 (for the American–European Consensus Conference (AECC) definition); mild, 36; moderate, 97; severe ARDS, 88 (for BD). Mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 25 % for severe ARDS, <Emphasis Type="Italic">p</Emphasis> = 0.04) and the composite outcome extracorporeal membrane oxygenation (ECMO)/mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 28.4 % for severe ARDS, <Emphasis Type="Italic">p</Emphasis> < 0.01) were different across the BD classes, whereas they were similar using the previous definition. Mortality [HR 2.7 (95 % CI 1.1–7.1)] and ECMO/mortality [HR 3 (95 % CI 1.1–7.9)] were increased only for the severe ARDS class and remained significant after adjustment for confounding factors. PICU stay was not different across severity classes, irrespective of the definition used. There was significant concordance between raters evaluating radiographs [ICC 0.6 (95 % CI 0.2–0.8)] and risk factors [ICC 0.92 (95 % CI 0.8–0.97)].</Para></AbstractSection><AbstractSection ID="ASec4"><Heading>Conclusions</Heading><Para>BD validity for children is similar to that already reported in adults and mainly due to the introduction of a “severe ARDS” category. We provided clinical tools to use BD for clinical practice, research, and health services planning in pediatric critical care.</Para></AbstractSection></Abstract><KeywordGroup Language="En" OutputMedium="All"><Heading>Keywords</Heading><Keyword>ARDS</Keyword><Keyword>Children</Keyword><Keyword>Diagnostic criteria</Keyword></KeywordGroup><ArticleNote Type="PresentedAt"><SimplePara>Partial results were presented as a late-breaking oral communication at the 24th Annual Meeting of the European Society of Pediatric and Neonatal Intensive Care, Rotterdam (NL), June 2013.</SimplePara></ArticleNote><ArticleNote Type="Misc"><SimplePara>A related editorial can be found at: doi:<ExternalRef><RefSource>10.1007/s00134-013-3094-6</RefSource><RefTarget Address="10.1007/s00134-013-3094-6" TargetType="DOI"></RefTarget></ExternalRef>.</SimplePara></ArticleNote><ArticleNote Type="ESMHint"><Heading>Electronic supplementary material</Heading><SimplePara>The online version of this article (doi:<ExternalRef><RefSource>10.1007/s00134-013-3110-x</RefSource><RefTarget Address="10.1007/s00134-013-3110-x" TargetType="DOI"></RefTarget></ExternalRef>) contains supplementary material, which is available to authorized users.</SimplePara></ArticleNote></ArticleHeader><NoBody></NoBody></Article></Issue></Volume></Journal></Publisher></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>The use of the Berlin definition for acute respiratory distress syndrome during infancy and early childhood: multicenter evaluation and expert consensus</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>The use of the Berlin definition for acute respiratory distress syndrome during infancy and early childhood: multicenter evaluation and expert consensus</title></titleInfo><name type="corporate"><namePart>On behalf of Respiratory Section of the European Society for Pediatric Neonatal Intensive Care (ESPNIC)</namePart><affiliation>1-3 Rue de Chantepoulet, P.O. Box 1726, 1211, Geneva 1, Switzerland</affiliation></name><name type="personal" displayLabel="corresp"><namePart type="given">Daniele</namePart><namePart type="family">De Luca</namePart><affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</affiliation><affiliation>Neonatal Intensive Care Unit, CHU Antoine Béclère, South Paris University Teaching Hospitals, Paris, France</affiliation><affiliation>Terapia Intensiva Pediatrica–DEA, Policlinico Universitario “A. Gemelli”–Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy</affiliation><affiliation>E-mail: daniele.deluca@rm.unicatt.it</affiliation><affiliation>E-mail: dm.deluca@fastwebnet.it</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marco</namePart><namePart type="family">Piastra</namePart><affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Giovanna</namePart><namePart type="family">Chidini</namePart><affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pierre</namePart><namePart type="family">Tissieres</namePart><affiliation>Pediatric Intensive Care Unit, CHU Kremlin-Bicetre, South Paris University Teaching Hospitals, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Edoardo</namePart><namePart type="family">Calderini</namePart><affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sandrine</namePart><namePart type="family">Essouri</namePart><affiliation>Pediatric Intensive Care Unit, CHU Kremlin-Bicetre, South Paris University Teaching Hospitals, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alberto</namePart><namePart type="family">Medina Villanueva</namePart><affiliation>Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario de Asturias, Oviedo, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ana</namePart><namePart type="family">Vivanco Allende</namePart><affiliation>Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario de Asturias, Oviedo, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marti</namePart><namePart type="family">Pons-Odena</namePart><affiliation>Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics, Hospital Universitari Sant Joan de Déu, Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Luis</namePart><namePart type="family">Perez-Baena</namePart><affiliation>Pediatric Intensive Care and Intermediate Care Unit, Department of Pediatrics, Hospital Universitari Sant Joan de Déu, Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michael</namePart><namePart type="family">Hermon</namePart><affiliation>Division of Neonatology, Intensive Care and Neuro-pediatrics, Medical University of Vienna, Vienna, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ascanio</namePart><namePart type="family">Tridente</namePart><affiliation>Intensive Care Unit, Whiston Hospital, St. Helen’s and Knowsley Teaching Hospitals NHS Trust, UK and academic Unit of Medical Education, Sheffield Medical School, University of Sheffield, Sheffield, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Giorgio</namePart><namePart type="family">Conti</namePart><affiliation>Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Massimo</namePart><namePart type="family">Antonelli</namePart><affiliation>General Intensive Care Unit, Department of Anesthesia and Intensive Care, University Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Martin</namePart><namePart type="family">Kneyber</namePart><affiliation>Pediatric Intensive Care Unit, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="OriginalPaper" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Springer Berlin Heidelberg</publisher><place><placeTerm type="text">Berlin/Heidelberg</placeTerm></place><dateCreated encoding="w3cdtf">2013-05-27</dateCreated><dateIssued encoding="w3cdtf">2013-12-01</dateIssued><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract lang="en">Abstract: Purpose: A new acute respiratory distress syndrome (ARDS) definition has been recently issued: the so-called Berlin definition (BD) has some characteristics that could make it suitable for pediatrics. The European Society for Pediatric Neonatal Intensive Care (ESPNIC) Respiratory Section started a project to evaluate BD validity in early childhood. A secondary aim was reaching a consensus on clinical tools (risk factors list and illustrative radiographs) to help the application of BD. Methods: This was an international, multicenter, retrospective study enrolling 221 children [aged greater than 30 days and less than 18 months; median age 6 (range 2–13) months], admitted to seven European pediatric intensive care units (PICU) with acute lung injury (ALI) or ARDS diagnosed with the earlier definition. Results: Patients were categorized according to the two definitions, as follows: ALI, 36; ARDS, 185 (for the American–European Consensus Conference (AECC) definition); mild, 36; moderate, 97; severe ARDS, 88 (for BD). Mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 25 % for severe ARDS, p = 0.04) and the composite outcome extracorporeal membrane oxygenation (ECMO)/mortality (13.9 % for mild ARDS; 11.3 % for moderate ARDS; 28.4 % for severe ARDS, p < 0.01) were different across the BD classes, whereas they were similar using the previous definition. Mortality [HR 2.7 (95 % CI 1.1–7.1)] and ECMO/mortality [HR 3 (95 % CI 1.1–7.9)] were increased only for the severe ARDS class and remained significant after adjustment for confounding factors. PICU stay was not different across severity classes, irrespective of the definition used. There was significant concordance between raters evaluating radiographs [ICC 0.6 (95 % CI 0.2–0.8)] and risk factors [ICC 0.92 (95 % CI 0.8–0.97)]. Conclusions: BD validity for children is similar to that already reported in adults and mainly due to the introduction of a “severe ARDS” category. We provided clinical tools to use BD for clinical practice, research, and health services planning in pediatric critical care.</abstract><note>Seven-Day Profile Publication</note><subject lang="en"><genre>Keywords</genre><topic>ARDS</topic><topic>Children</topic><topic>Diagnostic criteria</topic></subject><relatedItem type="host"><titleInfo><title>Intensive Care Medicine</title></titleInfo><titleInfo type="abbreviated"><title>Intensive Care Med</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>Springer</publisher><dateIssued encoding="w3cdtf">2013</dateIssued><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><subject><genre>Journal-Subject-Collection</genre><topic authority="SpringerSubjectCodes" authorityURI="SC11">Medicine</topic></subject><classification authority="Journal-SubjectCollection-Code">SC11</classification><subject><genre>Journal-Subject-Group</genre><topic authority="SpringerSubjectCodes" authorityURI="SCH">Medicine & Public Health</topic><topic authority="SpringerSubjectCodes" authorityURI="SCH3100X">Intensive / Critical Care Medicine</topic><topic authority="SpringerSubjectCodes" authorityURI="SCH13001">Anesthesiology</topic><topic authority="SpringerSubjectCodes" authorityURI="SCH22000">Emergency Medicine</topic><topic authority="SpringerSubjectCodes" authorityURI="SCH33134">Pneumology/Respiratory System</topic><topic authority="SpringerSubjectCodes" authorityURI="SCH47003">Pain Medicine</topic><topic authority="SpringerSubjectCodes" authorityURI="SCH49006">Pediatrics</topic></subject><identifier type="ISSN">0342-4642</identifier><identifier type="eISSN">1432-1238</identifier><identifier type="JournalID">134</identifier><identifier type="IssueArticleCount">34</identifier><identifier type="VolumeIssueCount">12</identifier><part><date>2013</date><detail type="volume"><number>39</number><caption>vol.</caption></detail><detail type="issue"><number>12</number><caption>no.</caption></detail><extent unit="pages"><start>2083</start><end>2091</end></extent></part><recordInfo><recordOrigin>Springer-Verlag Berlin Heidelberg and ESICM, 2013</recordOrigin></recordInfo></relatedItem><relatedItem type="otherVersion"></relatedItem><identifier type="istex">0879E74D661E8A1B93A6DEB58D4004188719E455</identifier><identifier type="ark">ark:/67375/VQC-6M0WKS1C-V</identifier><identifier type="DOI">10.1007/s00134-013-3110-x</identifier><identifier type="ArticleID">3110</identifier><identifier type="ArticleID">s00134-013-3110-x</identifier><accessCondition type="use and reproduction" contentType="copyright">Springer-Verlag Berlin Heidelberg and ESICM, 2013</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-3XSW68JL-F">springer</recordContentSource><recordOrigin>Converted from (version 1.2.14) to MODS version 3.6.</recordOrigin><recordCreationDate encoding="w3cdtf">2020-05-28</recordCreationDate></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-6M0WKS1C-V/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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