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The Application of Point-of-Care Ultrasonography (POCUS) in the Management of Acute Respiratory Distress Syndrome (ARDS) in the Intensive Care Unit
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Clinical Practice Guideline of Acute Respiratory Distress Syndrome

Young-Jae Cho1, Jae Young Moon2, Ein-Soon Shin3

  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Tuberculosis and Respiratory Diseases
|October 30, 2016
PubMed

Insights

This study provides practical guidelines for mechanical ventilation in patients with or without acute respiratory distress syndrome (ARDS). Key recommendations include low tidal volume ventilation and prone positioning for ARDS patients to reduce mortality.

Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Respiratory Therapy

Background:

  • Lack of established practical guidelines for mechanical ventilation in patients with or without Acute Respiratory Distress Syndrome (ARDS).
  • Need for evidence-based recommendations to optimize patient outcomes and reduce mortality.

Approach:

  • Development of strong (1) and weak (2) grade recommendations based on evidence quality (A, B, C).
  • Systematic review and synthesis of existing research to formulate clinical guidance.

Key Points:

  • For ARDS patients: recommend low tidal volume ventilation (1A) and prone positioning (1B) to decrease mortality.
  • Do not support high-frequency oscillatory ventilation (1B) or inhaled nitric oxide (1A) as standard treatments.
  • Suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as rescue (2C), and neuromuscular blockade for 48 hours (2B).
  • Recruitment maneuvers may reduce mortality (2B); systemic steroids do not (2B).
  • For all mechanically ventilated patients: recommend light sedation (1B) and low tidal volume (1B).
  • Suggest lung protective ventilation during surgery (2B) to prevent ARDS.
  • Early tracheostomy is indicated for limited patients (2A).

Conclusions:

  • The guidelines offer 12 recommendations, with nine focused on ARDS management and three for general mechanical ventilation.
  • These evidence-based recommendations aim to improve clinical practice and patient outcomes in respiratory care.

Keywords:
Practice GuidelineRespiration, ArtificialRespiratory Distress Syndrome, AcuteRespiratory Distress Syndrome, AdultVentilators, Mechanical

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