Non-pulmonary Specific Treatment

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Use of sedatives in children supported on mechanical ventilation is highly common despite lacking sound scientific evidence for this practice [142]. So far, there is no data specifically focusing on PARDS patients. Two recent trials did not confirm a beneficial effect of either protocolised sedation or a daily interruption of sedation on patient outcome [33, 144]. Both trials however did also include patients other than those with PARDS.

Neuromuscular Blockade

High-quality evidence to guide the use of neuromuscular blockade (NMB) in children with PARDS supported by mechanical ventilation is lacking. Papazian and colleagues showed improved 90-day survival and increased time off the ventilator without increased muscular weakness associated with early use of NMB in N = 340 adults with severe ARDS (PaO2/FiO2 < 150) in a multicentre double-blind randomised controlled trial [112]. It is unclear if such beneficial effects of NMB can also be seen in PARDS.

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