Reihan Athala Rizki Putranda, Hadi Suwono
This review article addresses the unique challenges posed by pediatric acute respiratory distress syndrome (ARDS) and emphasizes the need for tailored management strategies distinct from those utilized in adult cases. Recent advancements in physiological monitoring, including transpulmonary and pleural pressure measurements, as well as electrical impedance tomography (EIT), are being explored for their potential to enhance individualized ventilation strategies in real-time. These tools facilitate a better understanding of patient-specific lung mechanics, optimizing positive end-expiratory pressure (PEEP) while minimizing risks such as lung overdistension and atelectrauma. The heterogeneous nature of pediatric ARDS underscores the importance of personalized treatment approaches rather than relying on generalized adult-derived protocols. The role of extracorporeal membrane oxygenation (ECMO) as a valuable therapy for severe pediatric ARDS cases is evaluated, highlighting improved outcomes when effectively indicated. However, the ideal ventilatory parameters for its use remain uncertain. This review also discusses the importance of implementing sustainable hospital design principles that promote child-friendly environments and prioritize comprehensive pediatric care, taking into account both environmental and psychosocial factors. Challenges faced in Indonesia, including limited training and resources, are examined, stressing the need for enhanced clinician education and adherence to lung-protective protocols. The paper advocates for a comprehensive strategy that integrates clinical protocol implementation, infrastructure development, and the adoption of advanced technology to enhance pediatric ARDS care. Future research should focus on establishing optimal management practices and long-term outcomes tailored to this vulnerable population. © 2025 The authors. This article is published by IIETA and is licensed under the CC BY 4.0 license(http://creativecommons.org/licenses/by/4.0/).
IHC Elizabeth Hospital, Situbondo, 68111, Indonesia; Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Negeri Malang, Malang, 65146, Indonesia; Center of Research and Innovation in STEM Education, Faculty of Mathematics and Natural Sciences, Universitas Negeri Malang, Malang, 65146, Indonesia
