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Clinical Practice Guideline of Acute Respiratory Distress Syndrome

Authors
 Young-Jae Cho  ;  Jae Young Moon  ;  Ein-Soon Shin  ;  Je Hyeong Kim  ;  Hoon Jung  ;  So Young Park  ;  Ho Cheol Kim  ;  Yun Su Sim  ;  Chin Kook Rhee  ;  Jaemin Lim  ;  Seok Jeong Lee  ;  Won-Yeon Lee  ;  Hyun Jeong Lee  ;  Sang Hyun Kwak  ;  Eun Kyeong Kang  ;  Kyung Soo Chung  ;  Won-Il Choi  ;  The Korean Society of Critical Care Medicine  ;  The Korean Academy of Tuberculosis and Respiratory Diseases Consensus Group 
Citation
 TUBERCULOSIS AND RESPIRATORY DISEASES, Vol.79(4) : 214-233, 2016 
Journal Title
 TUBERCULOSIS AND RESPIRATORY DISEASES 
ISSN
 1738-3536 
Issue Date
2016
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 end-expiratory 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.
Files in This Item:
T201604782.pdf Download
DOI
10.4046/trd.2016.79.4.214
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152624
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