Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps

Pediatric (PARDS) and neonatal (NARDS) acute respiratory distress syndrome have diferent age-specifc characteristics and defnitions. Trials on surfactant for ARDS in children and neonates have been performed well before the PARDS and NARDS defnitions and yielded conficting results. This is mainly du...

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Autores: De Luca, Daniele, Cogo, Paola E., Kneyber, Martin C., Biban, Paolo, Semple, Malcolm Grace, Pérez-Gil, Jesús, Conti, Giorgio, Tissieres, Pierre, Rimensberger, Peter C.
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/8185
Acceso en línea:https://hdl.handle.net/20.500.14352/8185
Access Level:acceso abierto
Palabra clave:577.112
616.2
Neonate
Infant
Children
PARDS
NARDS
Surfactant
Bioquímica (Medicina)
Neumología
3205.08 Enfermedades Pulmonares
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oai_identifier_str oai:docta.ucm.es:20.500.14352/8185
network_acronym_str ES
network_name_str España
repository_id_str
spelling Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research stepsDe Luca, DanieleCogo, Paola E.Kneyber, Martin C.Biban, PaoloSemple, Malcolm GracePérez-Gil, JesúsConti, GiorgioTissieres, PierreRimensberger, Peter C.577.112616.2NeonateInfantChildrenPARDSNARDSSurfactantBioquímica (Medicina)Neumología3205.08 Enfermedades PulmonaresPediatric (PARDS) and neonatal (NARDS) acute respiratory distress syndrome have diferent age-specifc characteristics and defnitions. Trials on surfactant for ARDS in children and neonates have been performed well before the PARDS and NARDS defnitions and yielded conficting results. This is mainly due to heterogeneity in study design refecting historic lack of pathobiology knowledge. We reviewed the available clinical and preclinical data to create an expert consensus aiming to inform future research steps and advance the knowledge in this area. Eight trials investigated the use of surfactant for ARDS in children and ten in neonates, respectively. There were improvements in oxygenation (7/8 trials in children, 7/10 in neonates) and mortality (3/8 trials in children, 1/10 in neonates) improved. Trials were heterogeneous for patients’ characteristics, surfactant type and administration strategy. Key pathobiologi cal concepts were missed in study design. Consensus with strong agreement was reached on four statements: 1. Tere are sufcient preclinical and clinical data to support targeted research on surfactant therapies for PARDS and NARDS. Studies should be performed according to the currently available defnitions and considering recent pathobiology knowledge. 2. PARDS and NARDS should be considered as syndromes and should be pre-clinically studied according to key characteristics, such as direct or indirect (primary or secondary) nature, clinical severity, infectious or noninfectious origin or patients’ age. 3. Explanatory should be preferred over pragmatic design for future trials on PARDS and NARDS. 4. Diferent clinical outcomes need to be chosen for PARDS and NARDS, according to the trial phase and design, trigger type, severity class and/or surfactant treatment policyBMCUniversidad Complutense de Madrid20212021-02-2220212021-02-22journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/8185reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución 3.0 Españahttps://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/81852026-06-02T12:44:21Z
dc.title.none.fl_str_mv Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps
title Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps
spellingShingle Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps
De Luca, Daniele
577.112
616.2
Neonate
Infant
Children
PARDS
NARDS
Surfactant
Bioquímica (Medicina)
Neumología
3205.08 Enfermedades Pulmonares
title_short Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps
title_full Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps
title_fullStr Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps
title_full_unstemmed Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps
title_sort Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps
dc.creator.none.fl_str_mv De Luca, Daniele
Cogo, Paola E.
Kneyber, Martin C.
Biban, Paolo
Semple, Malcolm Grace
Pérez-Gil, Jesús
Conti, Giorgio
Tissieres, Pierre
Rimensberger, Peter C.
author De Luca, Daniele
author_facet De Luca, Daniele
Cogo, Paola E.
Kneyber, Martin C.
Biban, Paolo
Semple, Malcolm Grace
Pérez-Gil, Jesús
Conti, Giorgio
Tissieres, Pierre
Rimensberger, Peter C.
author_role author
author2 Cogo, Paola E.
Kneyber, Martin C.
Biban, Paolo
Semple, Malcolm Grace
Pérez-Gil, Jesús
Conti, Giorgio
Tissieres, Pierre
Rimensberger, Peter C.
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 577.112
616.2
Neonate
Infant
Children
PARDS
NARDS
Surfactant
Bioquímica (Medicina)
Neumología
3205.08 Enfermedades Pulmonares
topic 577.112
616.2
Neonate
Infant
Children
PARDS
NARDS
Surfactant
Bioquímica (Medicina)
Neumología
3205.08 Enfermedades Pulmonares
description Pediatric (PARDS) and neonatal (NARDS) acute respiratory distress syndrome have diferent age-specifc characteristics and defnitions. Trials on surfactant for ARDS in children and neonates have been performed well before the PARDS and NARDS defnitions and yielded conficting results. This is mainly due to heterogeneity in study design refecting historic lack of pathobiology knowledge. We reviewed the available clinical and preclinical data to create an expert consensus aiming to inform future research steps and advance the knowledge in this area. Eight trials investigated the use of surfactant for ARDS in children and ten in neonates, respectively. There were improvements in oxygenation (7/8 trials in children, 7/10 in neonates) and mortality (3/8 trials in children, 1/10 in neonates) improved. Trials were heterogeneous for patients’ characteristics, surfactant type and administration strategy. Key pathobiologi cal concepts were missed in study design. Consensus with strong agreement was reached on four statements: 1. Tere are sufcient preclinical and clinical data to support targeted research on surfactant therapies for PARDS and NARDS. Studies should be performed according to the currently available defnitions and considering recent pathobiology knowledge. 2. PARDS and NARDS should be considered as syndromes and should be pre-clinically studied according to key characteristics, such as direct or indirect (primary or secondary) nature, clinical severity, infectious or noninfectious origin or patients’ age. 3. Explanatory should be preferred over pragmatic design for future trials on PARDS and NARDS. 4. Diferent clinical outcomes need to be chosen for PARDS and NARDS, according to the trial phase and design, trigger type, severity class and/or surfactant treatment policy
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-02-22
2021
2021-02-22
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/8185
url https://hdl.handle.net/20.500.14352/8185
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 3.0 España
https://creativecommons.org/licenses/by/3.0/es/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 3.0 España
https://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,198674

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