Acute Respiratory Distress Syndrome Management in Pediatric Intensive Care Units in Turkey: A Prospective Survey

Objective: This study aimed to explore the compliance of management strategies for pediatric acute respiratory distress syndrome in pediatric intensive care units in Turkey with current guidelines. Materials and Methods: This is a cross-sectional, prospective survey study. We delivered the survey, consisting of questions on topics in the relevant literature on acute respiratory distress syndrome management in children (1 month-18 years), to the heads/staff of the 100 units via email or phone. Results: In total, 51 (51%) out of 100 targeted pediatric intensive care units responded to the survey. We found out that 17 (33%) units comply with no acute respiratory distress syndrome guideline, while 65% frequently utilize cuffed endotracheal tubes. The majority of the units (86%) achieve their mechanical ventilation targets with the help of pressure control modes. Besides, steroid and surfactant use are present in 47% and 45% of the units, respectively, while 16% and 38% of the units use inhaled nitric oxide and high-frequency oscillatory ventilation, respectively. Conclusion: Lung-protective ventilation strategies preventing ventilator-associated lung injury are explicit in all responding units. The present survey revealed that current mechanical ventilation and non-ventilation treatment strategies in pediatric ARDS in Turkey are relatively uniform and largely consistent with international practices.