TABLE 1.

SUMMARY OF CONSIDERATIONS WHEN DESIGNING FUTURE TRIALS ON PEDIATRIC ACUTE LUNG INJURY/ACUTE RESPIRATORY DISTRESS SYNDROME

Careful consideration of the management of the lung-protective control group, particularly regarding targeted Vt based on lung injury severity

Optimization of lung-protective strategies for HFOV, NAVA, VDR, APRV

Determine the optimal body weight to target Vt

Determine circumstances in which proximal airway measurements are necessary for management

Develop explicit computerized protocols that are in line with current pediatric practice to optimize adherence

Embrace noninvasive oxygenation criteria for study recruitment

Design trials to minimize crossover and the use of rescue therapy

Use lung injury severity markers for initial stratification of risk and consider their use as entry criteria for studies

Validate measures of quality of life, long-term disability, neurodevelopment, and pulmonary function as outcome measures

Definition of abbreviations: APRV = airway pressure release ventilation; HFOV = high-frequency oscillatory ventilation; NAVA = neurally adjusted ventilatory assist; VDR = Volume Diffusive Respirator.