Jonathan A Silversides

TL;DR: The Faculty of Intensive Care Medicine and Intensive care Society Guideline Development Group have used GRADE methodology to make the following recommendations for the management of adult patients with acute respiratory distress syndrome (ARDS).

TL;DR: In adults and children with ARDS, sepsis or SIRS, a conservative or deresuscitative fluid strategy results in an increased number of ventilator-free days and a decreased length of ICU stay compared with a liberal strategy or standard care.

TL;DR: Fluid balance is a practice-dependent and potentially modifiable risk factor for adverse outcomes in critical illness and negative fluid balance achieved with deresuscitation on day 3 of ICU stay is associated with improved patient outcomes.

TL;DR: In this cohort of patients with AKI requiring RRT, a more positive mean daily fluid balance and intradialytic hypotension were associated with hospital mortality but not with RRT dependence at hospital discharge in survivors.

TL;DR: The current evidence base for ventilatory support and adjunctive therapies in patients with ARDS is discussed and key components of such a strategy include avoiding lung overdistension by limiting tidal volumes and airway pressures, and the use of positive end-expiratory pressure with or without lung recruitment manoeuvres in Patients with severe ARDS.