Corticosteroids treatment for pediatric acute respiratory syndrome: A critical review

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Figure 1
- A healthy alveolus with intact alveolar cell components and the vascular epithelial membrane is shown in the left panel. Following an acute inflammatory insult, alveolar alterations are seen in the right panel.
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Figure 2
- Routes by which corticosteroids in ARDS inhibit inflammation and interaction between NF-kB and activated corticosteroid receptor

Table 1

- Difference between different PARDS criterion.

Parameters	Previous criterion (1994)	Current criterion (2012)
Age	Includes patients of all ages	Pediatric patients (excludes individuals having perinatal lung disease)
Duration	Not specified	New known injury worsened within 7 days
Origin of edema	Pulmonary artery wedge pressure ≤17 mm Hg	Respiratory failure is not entirely explained by cardiac failure
Chest imaging	Bilateral infiltrate in radiography	New infiltrate with severe pulmonary parenchymal disease in radiography
Oxygenation	PaO₂/FiO₂: acute lung injury <300 mm Hg	PaO₂/FiO₂: mild: 200 to 300 mm Hg, moderate: 100 to 200 mm Hg, Severe: ≤100 mm Hg
Positive end-expiratory pressure	Not specified	≥5 cm H₂O
Steroid treatment	Late-stage PARDS treated with a high dose of steroids after 12 days of mechanical ventilation	Steroid treatment is prohibited