Establishing the entity of neonatal acute respiratory distress syndrome

Contemporary definitions for acute respiratory distress syndrome (ARDS) including the Berlin definition in adults and the Pediatric Acute Lung Injury Consensus Conference (PALICC) definition in children exclude perinatal lung diseases and newborns in general (1,2). This is based on the assumption that newborns frequently develop acute hypoxemic respiratory failure due to conditions such as respiratory distress syndrome (RDS) and transient tachypnea of the newborn which differ patho-physiologically from ARDS. Since the treatment of these perinatal conditions and prognosis differ, it is prudent not to label them as ARDS. However, direct and indirect ARDS do occur in a subset of term and preterm neonates (3). A neonatal ARDS definition is thus justified to increase awareness of a common ARDS spectrum amongst different intensive care disciplines, facilitate research on this condition and the use of specific ARDS therapies for these patients