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ARDS clinical practice guideline 2021.

Sadatomo Tasaka1, Shinichiro Ohshimo2, Muneyuki Takeuchi3

  • 1Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan.

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|June 26, 2022
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Summary
This summary is machine-generated.

The 2021 ARDS Clinical Practice Guideline provides updated recommendations for both adult and pediatric patients. Key findings include specific mechanical ventilation settings and steroid use for adults, and prone positioning for pediatric patients with moderate Acute Respiratory Distress Syndrome.

Keywords:
ARDSAcute lung injuryClinical practice guidelineSystematic review

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Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Pediatric Intensive Care

Background:

  • The Japanese Society of Intensive Care Medicine, Japanese Respiratory Society, and Japanese Society of Respiratory Care Medicine jointly developed the ARDS Clinical Practice Guideline 2021.
  • The 2021 guideline expands upon the 2016 edition by including clinical questions specifically for pediatric patients.

Purpose of the Study:

  • To provide evidence-based recommendations for the management of Acute Respiratory Distress Syndrome (ARDS) in both adult and pediatric populations.
  • To update clinical practice for ARDS based on the latest scientific evidence and systematic reviews.

Main Methods:

  • Systematic review methodology adhering to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
  • Inclusion of 46 clinical questions for adults and 15 for children.
  • Application of new methods such as diagnostic accuracy meta-analyses and network meta-analyses.

Main Results:

  • For adults: recommend tidal volume of 4-8 mL/kg, against targeting low SpO2, suggest ECMO for severe ARDS, and recommend low-dose steroids (GRADE 1B).
  • For pediatrics: suggest prone positioning for moderate ARDS, and against non-invasive respiratory support, NO inhalation, and daily sedation interruption (GRADE 2D).
  • Specific recommendations are provided regarding the use of biomarkers and transpulmonary pressure for ARDS management.

Conclusions:

  • The guideline offers updated, evidence-based recommendations for ARDS management in Japan.
  • This translated summary provides key insights for international healthcare professionals.
  • The original guideline may reflect perspectives specific to Japanese healthcare practices.