Clinical Practice Guideline of Acute Respiratory Distress Syndrome

Authors
Young-Jae ChoJae Young MoonEin-Soon ShinJe Hyeong KimHoon JungSo Young ParkHo Cheol KimYun Su SimChin Kook RheeJaemin LimSeok Jeong LeeWon-Yeon LeeHyun Jeong LeeSang Hyun KwakEun Kyeong KangKyung Soo ChungWon-Il Choi
Department
Dept. of Internal Medicine (내과학)
Issue Date
2016
Citation
Tuberculosis and Respiratory Diseases, Vol.79(4) : 214-233, 2016
ISSN
1738-3536
Abstract
There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive endexpiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.
Keywords
Practice GuidelineRespiratory Distress SyndromeAdultAcuteVentilatorsMechanicalRespirationArtificial
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/33155
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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