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Formal guidelines: management of acute respiratory distress syndrome

Fifteen recommendations and a therapeutic algorithm regarding the management of acute respiratory distress syndrome (ARDS) at the early phase in adults are proposed. The Grade of Recommendation Assessment, Development and Evaluation (GRADE) methodology has been followed. Four recommendations (low ti...

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Autores principales: Papazian, Laurent, Aubron, Cécile, Brochard, Laurent, Chiche, Jean-Daniel, Combes, Alain, Dreyfuss, Didier, Forel, Jean-Marie, Guérin, Claude, Jaber, Samir, Mekontso-Dessap, Armand, Mercat, Alain, Richard, Jean-Christophe, Roux, Damien, Vieillard-Baron, Antoine, Faure, Henri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565761/
https://www.ncbi.nlm.nih.gov/pubmed/31197492
http://dx.doi.org/10.1186/s13613-019-0540-9
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author Papazian, Laurent
Aubron, Cécile
Brochard, Laurent
Chiche, Jean-Daniel
Combes, Alain
Dreyfuss, Didier
Forel, Jean-Marie
Guérin, Claude
Jaber, Samir
Mekontso-Dessap, Armand
Mercat, Alain
Richard, Jean-Christophe
Roux, Damien
Vieillard-Baron, Antoine
Faure, Henri
author_facet Papazian, Laurent
Aubron, Cécile
Brochard, Laurent
Chiche, Jean-Daniel
Combes, Alain
Dreyfuss, Didier
Forel, Jean-Marie
Guérin, Claude
Jaber, Samir
Mekontso-Dessap, Armand
Mercat, Alain
Richard, Jean-Christophe
Roux, Damien
Vieillard-Baron, Antoine
Faure, Henri
author_sort Papazian, Laurent
collection PubMed
description Fifteen recommendations and a therapeutic algorithm regarding the management of acute respiratory distress syndrome (ARDS) at the early phase in adults are proposed. The Grade of Recommendation Assessment, Development and Evaluation (GRADE) methodology has been followed. Four recommendations (low tidal volume, plateau pressure limitation, no oscillatory ventilation, and prone position) had a high level of proof (GRADE 1 + or 1 −); four (high positive end-expiratory pressure [PEEP] in moderate and severe ARDS, muscle relaxants, recruitment maneuvers, and venovenous extracorporeal membrane oxygenation [ECMO]) a low level of proof (GRADE 2 + or 2 −); seven (surveillance, tidal volume for non ARDS mechanically ventilated patients, tidal volume limitation in the presence of low plateau pressure, PEEP > 5 cmH2O, high PEEP in the absence of deleterious effect, pressure mode allowing spontaneous ventilation after the acute phase, and nitric oxide) corresponded to a level of proof that did not allow use of the GRADE classification and were expert opinions. Lastly, for three aspects of ARDS management (driving pressure, early spontaneous ventilation, and extracorporeal carbon dioxide removal), the experts concluded that no sound recommendation was possible given current knowledge. The recommendations and the therapeutic algorithm were approved by the experts with strong agreement.
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spelling pubmed-65657612019-06-28 Formal guidelines: management of acute respiratory distress syndrome Papazian, Laurent Aubron, Cécile Brochard, Laurent Chiche, Jean-Daniel Combes, Alain Dreyfuss, Didier Forel, Jean-Marie Guérin, Claude Jaber, Samir Mekontso-Dessap, Armand Mercat, Alain Richard, Jean-Christophe Roux, Damien Vieillard-Baron, Antoine Faure, Henri Ann Intensive Care Review Fifteen recommendations and a therapeutic algorithm regarding the management of acute respiratory distress syndrome (ARDS) at the early phase in adults are proposed. The Grade of Recommendation Assessment, Development and Evaluation (GRADE) methodology has been followed. Four recommendations (low tidal volume, plateau pressure limitation, no oscillatory ventilation, and prone position) had a high level of proof (GRADE 1 + or 1 −); four (high positive end-expiratory pressure [PEEP] in moderate and severe ARDS, muscle relaxants, recruitment maneuvers, and venovenous extracorporeal membrane oxygenation [ECMO]) a low level of proof (GRADE 2 + or 2 −); seven (surveillance, tidal volume for non ARDS mechanically ventilated patients, tidal volume limitation in the presence of low plateau pressure, PEEP > 5 cmH2O, high PEEP in the absence of deleterious effect, pressure mode allowing spontaneous ventilation after the acute phase, and nitric oxide) corresponded to a level of proof that did not allow use of the GRADE classification and were expert opinions. Lastly, for three aspects of ARDS management (driving pressure, early spontaneous ventilation, and extracorporeal carbon dioxide removal), the experts concluded that no sound recommendation was possible given current knowledge. The recommendations and the therapeutic algorithm were approved by the experts with strong agreement. Springer International Publishing 2019-06-13 /pmc/articles/PMC6565761/ /pubmed/31197492 http://dx.doi.org/10.1186/s13613-019-0540-9 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
Papazian, Laurent
Aubron, Cécile
Brochard, Laurent
Chiche, Jean-Daniel
Combes, Alain
Dreyfuss, Didier
Forel, Jean-Marie
Guérin, Claude
Jaber, Samir
Mekontso-Dessap, Armand
Mercat, Alain
Richard, Jean-Christophe
Roux, Damien
Vieillard-Baron, Antoine
Faure, Henri
Formal guidelines: management of acute respiratory distress syndrome
title Formal guidelines: management of acute respiratory distress syndrome
title_full Formal guidelines: management of acute respiratory distress syndrome
title_fullStr Formal guidelines: management of acute respiratory distress syndrome
title_full_unstemmed Formal guidelines: management of acute respiratory distress syndrome
title_short Formal guidelines: management of acute respiratory distress syndrome
title_sort formal guidelines: management of acute respiratory distress syndrome
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565761/
https://www.ncbi.nlm.nih.gov/pubmed/31197492
http://dx.doi.org/10.1186/s13613-019-0540-9
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