Acute lung injury in the child

SummaryAcute lung injury(ALI) is an important condition in critically ill children, contributing to overall mortality and morbidity. ALI represents the severe spectrum of lower airways disease in children. It is the pathological culmination of diseases such as pneumonia and sepsis. These conditions elicit a host response, which results in a clinically and radiologically defined pulmonary syndrome, leading to additional physiological burden. Despite ALI being well described in the paediatric age group, its management has been largely based on adult studies. Ventilatory support with low tidal volumes, positive end expiratory pressure(PEEP) and permissive hypercapnoea are the pillars of management – derived from adult studies. For those caring for critically unwell children, this review outlines recent paediatric studies, current therapies in the context of available literature and novel emerging approaches.