An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome
This document provides evidence-based clinical practice guidelines on the use of mechanical ventilation in adult patients with acute respiratory distress syndrome (ARDS). A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommend...
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| Veröffentlicht in: | American journal of respiratory and critical care medicine 2017-05, Vol.195 (9), p.1253-1263 |
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| container_title | American journal of respiratory and critical care medicine |
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| creator | Fan, Eddy Del Sorbo, Lorenzo Goligher, Ewan C Hodgson, Carol L Munshi, Laveena Walkey, Allan J Adhikari, Neill K J Amato, Marcelo B P Branson, Richard Brower, Roy G Ferguson, Niall D Gajic, Ognjen Gattinoni, Luciano Hess, Dean Mancebo, Jordi Meade, Maureen O McAuley, Daniel F Pesenti, Antonio Ranieri, V Marco Rubenfeld, Gordon D Rubin, Eileen Seckel, Maureen Slutsky, Arthur S Talmor, Daniel Thompson, B Taylor Wunsch, Hannah Uleryk, Elizabeth Brozek, Jan Brochard, Laurent J |
| description | This document provides evidence-based clinical practice guidelines on the use of mechanical ventilation in adult patients with acute respiratory distress syndrome (ARDS).
A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.
For all patients with ARDS, the recommendation is strong for mechanical ventilation using lower tidal volumes (4-8 ml/kg predicted body weight) and lower inspiratory pressures (plateau pressure |
| doi_str_mv | 10.1164/rccm.201703-0548ST |
| format | Article |
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A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.
For all patients with ARDS, the recommendation is strong for mechanical ventilation using lower tidal volumes (4-8 ml/kg predicted body weight) and lower inspiratory pressures (plateau pressure < 30 cm H
O) (moderate confidence in effect estimates). For patients with severe ARDS, the recommendation is strong for prone positioning for more than 12 h/d (moderate confidence in effect estimates). For patients with moderate or severe ARDS, the recommendation is strong against routine use of high-frequency oscillatory ventilation (high confidence in effect estimates) and conditional for higher positive end-expiratory pressure (moderate confidence in effect estimates) and recruitment maneuvers (low confidence in effect estimates). Additional evidence is necessary to make a definitive recommendation for or against the use of extracorporeal membrane oxygenation in patients with severe ARDS.
The panel formulated and provided the rationale for recommendations on selected ventilatory interventions for adult patients with ARDS. Clinicians managing patients with ARDS should personalize decisions for their patients, particularly regarding the conditional recommendations in this guideline.</description><identifier>ISSN: 1073-449X</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/rccm.201703-0548ST</identifier><identifier>PMID: 28459336</identifier><language>eng</language><publisher>United States: American Thoracic Society</publisher><subject>Adult ; Chest Wall Oscillation - standards ; Clinical medicine ; Clinical practice guidelines ; Committees ; Confidentiality ; Critical care ; Extracorporeal Membrane Oxygenation - standards ; Humans ; Intellectual property ; Intensive care ; Medicine ; Patients ; Pharmaceuticals ; Positive-Pressure Respiration - methods ; Positive-Pressure Respiration - standards ; Prone Position ; Respiration, Artificial - methods ; Respiration, Artificial - standards ; Respiratory distress syndrome ; Respiratory Distress Syndrome - therapy ; Respiratory therapy ; Royalties</subject><ispartof>American journal of respiratory and critical care medicine, 2017-05, Vol.195 (9), p.1253-1263</ispartof><rights>Copyright American Thoracic Society May 1, 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-6f34df9b21082646cf1e7175d681ff4b20c1ff1d6b0338806822928125997bc53</citedby><cites>FETCH-LOGICAL-c380t-6f34df9b21082646cf1e7175d681ff4b20c1ff1d6b0338806822928125997bc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4011,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28459336$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fan, Eddy</creatorcontrib><creatorcontrib>Del Sorbo, Lorenzo</creatorcontrib><creatorcontrib>Goligher, Ewan C</creatorcontrib><creatorcontrib>Hodgson, Carol L</creatorcontrib><creatorcontrib>Munshi, Laveena</creatorcontrib><creatorcontrib>Walkey, Allan J</creatorcontrib><creatorcontrib>Adhikari, Neill K J</creatorcontrib><creatorcontrib>Amato, Marcelo B P</creatorcontrib><creatorcontrib>Branson, Richard</creatorcontrib><creatorcontrib>Brower, Roy G</creatorcontrib><creatorcontrib>Ferguson, Niall D</creatorcontrib><creatorcontrib>Gajic, Ognjen</creatorcontrib><creatorcontrib>Gattinoni, Luciano</creatorcontrib><creatorcontrib>Hess, Dean</creatorcontrib><creatorcontrib>Mancebo, Jordi</creatorcontrib><creatorcontrib>Meade, Maureen O</creatorcontrib><creatorcontrib>McAuley, Daniel F</creatorcontrib><creatorcontrib>Pesenti, Antonio</creatorcontrib><creatorcontrib>Ranieri, V Marco</creatorcontrib><creatorcontrib>Rubenfeld, Gordon D</creatorcontrib><creatorcontrib>Rubin, Eileen</creatorcontrib><creatorcontrib>Seckel, Maureen</creatorcontrib><creatorcontrib>Slutsky, Arthur S</creatorcontrib><creatorcontrib>Talmor, Daniel</creatorcontrib><creatorcontrib>Thompson, B Taylor</creatorcontrib><creatorcontrib>Wunsch, Hannah</creatorcontrib><creatorcontrib>Uleryk, Elizabeth</creatorcontrib><creatorcontrib>Brozek, Jan</creatorcontrib><creatorcontrib>Brochard, Laurent J</creatorcontrib><creatorcontrib>American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine</creatorcontrib><title>An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome</title><title>American journal of respiratory and critical care medicine</title><addtitle>Am J Respir Crit Care Med</addtitle><description>This document provides evidence-based clinical practice guidelines on the use of mechanical ventilation in adult patients with acute respiratory distress syndrome (ARDS).
A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.
For all patients with ARDS, the recommendation is strong for mechanical ventilation using lower tidal volumes (4-8 ml/kg predicted body weight) and lower inspiratory pressures (plateau pressure < 30 cm H
O) (moderate confidence in effect estimates). For patients with severe ARDS, the recommendation is strong for prone positioning for more than 12 h/d (moderate confidence in effect estimates). For patients with moderate or severe ARDS, the recommendation is strong against routine use of high-frequency oscillatory ventilation (high confidence in effect estimates) and conditional for higher positive end-expiratory pressure (moderate confidence in effect estimates) and recruitment maneuvers (low confidence in effect estimates). Additional evidence is necessary to make a definitive recommendation for or against the use of extracorporeal membrane oxygenation in patients with severe ARDS.
The panel formulated and provided the rationale for recommendations on selected ventilatory interventions for adult patients with ARDS. Clinicians managing patients with ARDS should personalize decisions for their patients, particularly regarding the conditional recommendations in this guideline.</description><subject>Adult</subject><subject>Chest Wall Oscillation - standards</subject><subject>Clinical medicine</subject><subject>Clinical practice guidelines</subject><subject>Committees</subject><subject>Confidentiality</subject><subject>Critical care</subject><subject>Extracorporeal Membrane Oxygenation - standards</subject><subject>Humans</subject><subject>Intellectual property</subject><subject>Intensive care</subject><subject>Medicine</subject><subject>Patients</subject><subject>Pharmaceuticals</subject><subject>Positive-Pressure Respiration - methods</subject><subject>Positive-Pressure Respiration - standards</subject><subject>Prone Position</subject><subject>Respiration, Artificial - methods</subject><subject>Respiration, Artificial - standards</subject><subject>Respiratory distress syndrome</subject><subject>Respiratory Distress Syndrome - therapy</subject><subject>Respiratory therapy</subject><subject>Royalties</subject><issn>1073-449X</issn><issn>1535-4970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdks1u1DAUhSMEoj_wAiyQJTZs0vFfEptdFNpSqagVMyB2UeJca1wl9tR2QPO6PAkeMiBgde1zv3ts2SfLXhF8QUjJV16p6YJiUmGW44KL9eZJdkoKVuRcVvhpWuOK5ZzLryfZWQgPGBMqCH6enVDBC8lYeZr9qC2609oo042onsAb1Vm02TrfKaPQ2ikDcb-6nL3bQeocBeQ0urERbDDfADWdB_QRhuRiYfUX0ngTk-H4L4Ga0dhf8n06JQGArmczQFLhXaLUtlvaX8BGM3bROIuMRfUwjxHdp33SA_pu4hbVao6APkHYGd9F5_fovQnRQwhovbeDdxO8yJ7pbgzw8ljPs89Xl5vmQ357d33T1Le5YgLHvNSMD1r2lGBBS14qTaAiVTGUgmjNe4pVqmQoe8yYELgUlMr0nrSQsupVwc6zt4vvzrvHGUJsJxMUjGNnwc2hJUIyWUpGqoS--Q99cLO36XYHiktKOCeJogulvAvBg2533kyd37cEt4cEtIcEtEsC2iUBaej10XruJxj-jPz-cvYTuy2wgg</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Fan, Eddy</creator><creator>Del Sorbo, Lorenzo</creator><creator>Goligher, Ewan C</creator><creator>Hodgson, Carol L</creator><creator>Munshi, Laveena</creator><creator>Walkey, Allan J</creator><creator>Adhikari, Neill K J</creator><creator>Amato, Marcelo B P</creator><creator>Branson, Richard</creator><creator>Brower, Roy G</creator><creator>Ferguson, Niall D</creator><creator>Gajic, Ognjen</creator><creator>Gattinoni, Luciano</creator><creator>Hess, Dean</creator><creator>Mancebo, Jordi</creator><creator>Meade, Maureen O</creator><creator>McAuley, Daniel F</creator><creator>Pesenti, Antonio</creator><creator>Ranieri, V Marco</creator><creator>Rubenfeld, Gordon D</creator><creator>Rubin, Eileen</creator><creator>Seckel, Maureen</creator><creator>Slutsky, Arthur S</creator><creator>Talmor, Daniel</creator><creator>Thompson, B Taylor</creator><creator>Wunsch, Hannah</creator><creator>Uleryk, Elizabeth</creator><creator>Brozek, Jan</creator><creator>Brochard, Laurent J</creator><general>American Thoracic Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome</title><author>Fan, Eddy ; Del Sorbo, Lorenzo ; Goligher, Ewan C ; Hodgson, Carol L ; Munshi, Laveena ; Walkey, Allan J ; Adhikari, Neill K J ; Amato, Marcelo B P ; Branson, Richard ; Brower, Roy G ; Ferguson, Niall D ; Gajic, Ognjen ; Gattinoni, Luciano ; Hess, Dean ; Mancebo, Jordi ; Meade, Maureen O ; McAuley, Daniel F ; Pesenti, Antonio ; Ranieri, V Marco ; Rubenfeld, Gordon D ; Rubin, Eileen ; Seckel, Maureen ; Slutsky, Arthur S ; Talmor, Daniel ; Thompson, B Taylor ; Wunsch, Hannah ; Uleryk, Elizabeth ; Brozek, Jan ; Brochard, Laurent J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-6f34df9b21082646cf1e7175d681ff4b20c1ff1d6b0338806822928125997bc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Chest Wall Oscillation - 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Academic</collection><jtitle>American journal of respiratory and critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fan, Eddy</au><au>Del Sorbo, Lorenzo</au><au>Goligher, Ewan C</au><au>Hodgson, Carol L</au><au>Munshi, Laveena</au><au>Walkey, Allan J</au><au>Adhikari, Neill K J</au><au>Amato, Marcelo B P</au><au>Branson, Richard</au><au>Brower, Roy G</au><au>Ferguson, Niall D</au><au>Gajic, Ognjen</au><au>Gattinoni, Luciano</au><au>Hess, Dean</au><au>Mancebo, Jordi</au><au>Meade, Maureen O</au><au>McAuley, Daniel F</au><au>Pesenti, Antonio</au><au>Ranieri, V Marco</au><au>Rubenfeld, Gordon D</au><au>Rubin, Eileen</au><au>Seckel, Maureen</au><au>Slutsky, Arthur S</au><au>Talmor, Daniel</au><au>Thompson, B Taylor</au><au>Wunsch, Hannah</au><au>Uleryk, Elizabeth</au><au>Brozek, Jan</au><au>Brochard, Laurent J</au><aucorp>American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome</atitle><jtitle>American journal of respiratory and critical care medicine</jtitle><addtitle>Am J Respir Crit Care Med</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>195</volume><issue>9</issue><spage>1253</spage><epage>1263</epage><pages>1253-1263</pages><issn>1073-449X</issn><eissn>1535-4970</eissn><abstract>This document provides evidence-based clinical practice guidelines on the use of mechanical ventilation in adult patients with acute respiratory distress syndrome (ARDS).
A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.
For all patients with ARDS, the recommendation is strong for mechanical ventilation using lower tidal volumes (4-8 ml/kg predicted body weight) and lower inspiratory pressures (plateau pressure < 30 cm H
O) (moderate confidence in effect estimates). For patients with severe ARDS, the recommendation is strong for prone positioning for more than 12 h/d (moderate confidence in effect estimates). For patients with moderate or severe ARDS, the recommendation is strong against routine use of high-frequency oscillatory ventilation (high confidence in effect estimates) and conditional for higher positive end-expiratory pressure (moderate confidence in effect estimates) and recruitment maneuvers (low confidence in effect estimates). Additional evidence is necessary to make a definitive recommendation for or against the use of extracorporeal membrane oxygenation in patients with severe ARDS.
The panel formulated and provided the rationale for recommendations on selected ventilatory interventions for adult patients with ARDS. Clinicians managing patients with ARDS should personalize decisions for their patients, particularly regarding the conditional recommendations in this guideline.</abstract><cop>United States</cop><pub>American Thoracic Society</pub><pmid>28459336</pmid><doi>10.1164/rccm.201703-0548ST</doi><tpages>11</tpages></addata></record> |
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| identifier | ISSN: 1073-449X |
| ispartof | American journal of respiratory and critical care medicine, 2017-05, Vol.195 (9), p.1253-1263 |
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| language | eng |
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| source | MEDLINE; American Thoracic Society (ATS) Journals Online; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Adult Chest Wall Oscillation - standards Clinical medicine Clinical practice guidelines Committees Confidentiality Critical care Extracorporeal Membrane Oxygenation - standards Humans Intellectual property Intensive care Medicine Patients Pharmaceuticals Positive-Pressure Respiration - methods Positive-Pressure Respiration - standards Prone Position Respiration, Artificial - methods Respiration, Artificial - standards Respiratory distress syndrome Respiratory Distress Syndrome - therapy Respiratory therapy Royalties |
| title | An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome |
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