Bibliographic Details
| Title: |
An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome: An Official American Thoracic Society Clinical Practice Guideline. |
| Authors: |
Qadir, Nida, Sahetya, Sarina, Munshi, Laveena, Summers, Charlotte, Abrams, Darryl, Beitler, Jeremy, Bellani, Giacomo, Brower, Roy G., Burry, Lisa, Jen-Ting Chen, Hodgson, Carol, Hough, Catherine L., Lamontagne, Francois, Law, Anica, Papazian, Laurent, Tai Pham, Rubin, Eileen, Siuba, Matthew, Telias, Irene, Patolia, Setu |
| Source: |
American Journal of Respiratory & Critical Care Medicine; 1/1/2024, Vol. 209 Issue 1, p24-36, 61p |
| Subject Terms: |
ADULT respiratory distress syndrome, POSITIVE end-expiratory pressure, PATIENT selection, EXTRACORPOREAL membrane oxygenation, NEUROMUSCULAR blocking agents |
| Company/Entity: |
AMERICAN Thoracic Society |
| Abstract: |
Background: This document updates previously published Clinical Practice Guidelines for the management of patients with acute respiratory distress syndrome (ARDS), incorporating new evidence addressing the use of corticosteroids, venovenous extracorporeal membrane oxygenation, neuromuscular blocking agents, and positive end-expiratory pressure (PEEP). Methods: We summarized evidence addressing four "PICO questions" (patient, intervention, comparison, and outcome). A multidisciplinary panel with expertise in ARDS used the Grading of Recommendations, Assessment, Development, and Evaluation framework to develop clinical recommendations. Results: We suggest the use of: 1) corticosteroids for patients with ARDS (conditional recommendation, moderate certainty of evidence), 2) venovenous extracorporeal membrane oxygenation in selected patients with severe ARDS (conditional recommendation, low certainty of evidence), 3) neuromuscular blockers in patients with early severe ARDS (conditional recommendation, low certainty of evidence), and 4) higher PEEP without lung recruitment maneuvers as opposed to lower PEEP in patients with moderate to severe ARDS (conditional recommendation, low to moderate certainty), and 5) we recommend against using prolonged lung recruitment maneuvers in patients with moderate to severe ARDS (strong recommendation, moderate certainty). Conclusions: We provide updated evidence-based recommendations for the management of ARDS. Individual patient and illness characteristics should be factored into clinical decision making and implementation of these recommendations while additional evidence is generated from much-needed clinical trials. [ABSTRACT FROM AUTHOR] |
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Copyright of American Journal of Respiratory & Critical Care Medicine is the property of American Thoracic Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Complementary Index |
