Table 1.

PARD Criteria (PALICC Guidelines)

PARDS baseline criteriaa
Acute onset; within 7 days of clinical insult
Chest imaging (radiograph or computed tomography) findings of new infiltrates (unilateral or bilateral) consistent with acute parenchymal disease
Edema not fully explained by fluid overload or cardiac failure
May present as new acute lung disease in setting of chronic lung disease and/or heart disease
Exclusions
Perinatal lung disease
PARDS severity stratification
	At-risk	Mild	Moderate	Severe
OI	<4 with O2 supplementation required to keep SpO2 > 88%	4 ≤ 8	8 ≤ 16	≥16
OSI	<5 with O2 supplementation required to keep SpO2 > 88%	5 ≤ 7.5	7.5 ≤ 12.3	≥12.3
Special considerations
Noninvasive ventilation
PARDS: P/F ratio ≤300 or SpO2/FiO2 ratio ≤264 on full face-mask noninvasive ventilation with minimum CPAP/EPAP ≥5 cm H2O (no severity stratification)
At-risk: requiring FiO2 ≥40% to attain SpO2 88%–92% with nasal mask CPAP/BiPAP or requiring age-based oxygen flow rate via mask or nasal cannula to maintain SpO2 88%–97%
<1 Year: 2 L/min
1–5 Years: 4 L/min
5–10 Years: 6 L/min
>10 Years: 8 L/min
Cyanotic heart disease: no specific OI or OSI cutoff; PARDS definition based on clinician determined “new-onset hypoxemia” in patient meeting other baseline criteria

^aPediatric acute respiratory distress syndrome.⁴

BIPAP, bilevel positive airway pressure; CPAP, continuous positive airway pressure; EPAP, expiratory positive airway pressure; OI, oxygenation index; OSI, oxygenation saturation index; PALICC, Pediatric Acute Lung Injury Consensus Conference; PARDS, pediatric acute respiratory distress syndrome; P/F, PaO₂/FiO₂.