Guidelines on the management of acute respiratory distress syndrome
Mark J.D. Griffiths,Daniel F. McAuley,Gavin D. Perkins,Nicholas Barrett,Bronagh Blackwood,Andrew J. Boyle,Nigel Chee,Bronwen Connolly,Paul Dark,Simon J. Finney,Aemun Salam,Jonathan A Silversides,Nick T Tarmey,Matt P. Wise,Simon Baudouin +14 more
TLDR
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).Abstract:
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). The British Thoracic Society supports the recommendations in this guideline. Where mechanical ventilation is required, the use of low tidal volumes (<6 ml/kg ideal body weight) and airway pressures (plateau pressure <30 cmH2O) was recommended. For patients with moderate/severe ARDS (PF ratio<20 kPa), prone positioning was recommended for at least 12 hours per day. By contrast, high frequency oscillation was not recommended and it was suggested that inhaled nitric oxide is not used. The use of a conservative fluid management strategy was suggested for all patients, whereas mechanical ventilation with high positive end-expiratory pressure and the use of the neuromuscular blocking agent cisatracurium for 48 hours was suggested for patients with ARDS with ratio of arterial oxygen partial pressure to fractional inspired oxygen (PF) ratios less than or equal to 27 and 20 kPa, respectively. Extracorporeal membrane oxygenation was suggested as an adjunct to protective mechanical ventilation for patients with very severe ARDS. In the absence of adequate evidence, research recommendations were made for the use of corticosteroids and extracorporeal carbon dioxide removal.read more
Citations
More filters
Journal ArticleDOI
COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted?
Eddy Fan,Eddy Fan,Jeremy R. Beitler,Laurent Brochard,Carolyn S. Calfee,Niall D. Ferguson,Niall D. Ferguson,Arthur S. Slutsky,Daniel Brodie +8 more
TL;DR: This Viewpoint addresses ventilatory strategies in the context of recent discussions on phenotypic heterogeneity in patients with COVID-19-associated ARDS, and strongly recommends adherence to evidence-based management, informed by bedside physiology, as resources permit.
Journal ArticleDOI
European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances.
Carsten Lott,Anatolij Truhlář,A. Alfonzo,A. Barelli,Violeta González-Salvado,Jochen Hinkelbein,Jerry P. Nolan,Jerry P. Nolan,Peter Paal,Gavin D. Perkins,Gavin D. Perkins,Karl-Christian Thies,Joyce Yeung,Joyce Yeung,David Zideman,Jasmeet Soar,Gamal Eldin Abbas Khalifa,Efrén Álvarez,Roberta Barelli,Joost J.L.M. Bierens,Bernd Boettiger,Guttorm Brattebø,Douglas Browne,Hermann Brugger,Tomasz Darocha,Charles D. Deakin,Joel Dunning,Silvija Hunyadi-Anticevic,Rudolph W. Koster,David Lockey,Mathieu Pasquier,Jan Schmitz +31 more
TL;DR: These European Resuscitation Council (ERC) Cardiac Arrest in Special Circumstances guidelines are based on the 2020 International Consensus on Cardiopulmonary Resusitation Science with Treatment Recommendations as mentioned in this paper.
Journal ArticleDOI
COVID-19 Infection: Implications for Perioperative and Critical Care Physicians.
TL;DR: A comprehensive review of COVID-19 pathogenesis, presentation, diagnosis, and potential therapeutics summarizes management recommendations in critical care and perioperative settings, based on current understanding of coronavirus biology and acute respiratory distress syndrome pathophysiology.
Journal ArticleDOI
COVID-19 and pneumothorax: a multicentre retrospective case series
Anthony W. Martinelli,Tejas Ingle,Joseph Newman,Iftikhar Nadeem,Karl Jackson,Nicholas Lane,Nicholas Lane,James Melhorn,Helen E. Davies,Anthony J. Rostron,Aldrin Adeni,Kevin Conroy,Nick Woznitza,Matthew Matson,Simon E. Brill,James Murray,AJ Shah,Revati Naran,S.S. Hare,Oliver Collas,Sarah Bigham,Michael Spiro,Margaret M. Huang,Beenish Iqbal,Sarah Trenfield,Stephane Ledot,Sujal R. Desai,Lewis Standing,Judith Babar,Razeen Mahroof,Ian Smith,Kai Lee,Nairi Tchrakian,Stephanie Uys,William Ricketts,Anant Patel,Avinash Aujayeb,Maria Kokosi,Alexander J.K. Wilkinson,Stefan J. Marciniak +39 more
TL;DR: Pneumothorax does not seem to be an independent marker of poor prognosis and it is suggested that pneumothsorax is a complication of COVID-19.
Posted Content
Abnormal respiratory patterns classifier may contribute to large-scale screening of people infected with COVID-19 in an accurate and unobtrusive manner
TL;DR: A novel and efficient Respiratory Simulation Model (RSM) is proposed to fill the gap between the large amount of training data and scarce real-world data and have the great potential to be extended to large scale applications such as public places, sleep scenario, and office environment.
References
More filters
Book
Cochrane Handbook for Systematic Reviews of Interventions
Julian P T Higgins,Sally Green +1 more
TL;DR: The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.
Journal Article
Cochrane Handbook for Systematic Reviews of Interventions
Journal ArticleDOI
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Gordon H. Guyatt,Andrew D Oxman,Gunn Elisabeth Vist,Regina Kunz,Yngve Falck-Ytter,Pablo Alonso-Coello,Holger J. Schünemann +6 more
TL;DR: The advantages of the GRADE system are explored, which is increasingly being adopted by organisations worldwide and which is often praised for its high level of consistency.
Journal ArticleDOI
Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.
Roy G. Brower,Michael A. Matthay,Alan H. Morris,David A. Schoenfeld,B. Taylor Thompson,Arthur P. Wheeler +5 more
TL;DR: In patients with acute lung injury and the acute respiratory distress syndrome, mechanical ventilation with a lower tidal volume than is traditionally used results in decreased mortality and increases the number of days without ventilator use.
Journal ArticleDOI
The American-European Consensus Conference on ARDS: Definitions, mechanisms, relevant outcomes, and clinical trial coordination
Gordon R. Bernard,Antonio Artigas,Kenneth L. Brigham,J. Carlet,K. Falke,L. Hudson,M. Lamy,J. R. LeGall,Alan H. Morris,Roger G. Spragg +9 more
TL;DR: The acute respiratory distress syndrome (ARDS), a process of nonhydrostatic pulmonary edema and hypoxemia associated with a variety of etiologies, carries a high morbidity, mortality, and financial cost.
Related Papers (5)
Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries
Giacomo Bellani,John G. Laffey,John G. Laffey,Tài Pham,Tài Pham,Eddy Fan,Eddy Fan,Laurent Brochard,Laurent Brochard,Andrés Esteban,Luciano Gattinoni,Frank van Haren,Anders Larsson,Daniel F. McAuley,Marco Ranieri,Gordon D. Rubenfeld,Gordon D. Rubenfeld,B. Taylor Thompson,Hermann Wrigge,Arthur S. Slutsky,Antonio Pesenti +20 more
Prone Positioning in Severe Acute Respiratory Distress Syndrome
Claude Guérin,Jean Reignier,Jean-Christophe Richard,Pascal Beuret,Arnaud Gacouin,Thierry Boulain,Emmanuelle Mercier,Michel Badet,Alain Mercat,Olivier Baudin,Marc Clavel,Delphine Chatellier,Samir Jaber,Sylvène Rosselli,Jordi Mancebo,Michel Sirodot,Gilles Hilbert,Christian Bengler,Jack Richecoeur,Marc Gainnier,Frédérique Bayle,Gael Bourdin,Véronique Leray,Raphaële Girard,Loredana Baboi,Louis Ayzac +25 more