ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategies
Рекомендации ESICM по острому респираторному дистресс-синдрому: определение, фенотипирование и стратегии респираторной поддержки
2023-06-16
SCID: 54.1/v5bhyxhq
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acute respiratory distress syndromehigh-flow nasal cannula oxygennon-invasive ventilationprone positioningrespiratory support strategies
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Abstract (AI)
The aim of these guidelines is to update the 2017 clinical practice guideline (CPG) of the European Society of Intensive Care Medicine (ESICM). The scope of this CPG is limited to adult patients and to non-pharmacological respiratory support strategies across different aspects of acute respiratory distress syndrome (ARDS), including ARDS due to coronavirus disease 2019 (COVID-19). These guidelines were formulated by an international panel of clinical experts, one methodologist and patients' representatives on behalf of the ESICM. The review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence and grade recommendations and the quality of reporting of each study based on the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) network guidelines. The CPG addressed 21 questions and formulates 21 recommendations on the following domains: (1) definition; (2) phenotyping, and respiratory support strategies including (3) high-flow nasal cannula oxygen (HFNO); (4) non-invasive ventilation (NIV); (5) tidal volume setting; (6) positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM); (7) prone positioning; (8) neuromuscular blockade, and (9) extracorporeal life support (ECLS). In addition, the CPG includes expert opinion on clinical practice and identifies the areas of future research.
Key Findings
1
Expert opinion and identified priorities for future research supplement the evidence-based recommendations, reflecting areas with limited evidence.
2
It develops 21 evidence-graded recommendations addressing ARDS definition, phenotyping, and non-pharmacological respiratory support strategies.
3
Recommendations cover HFNO, NIV, tidal-volume setting, PEEP, recruitment maneuvers, prone positioning, neuromuscular blockade, and extracorporeal life support.
4
The guideline updates the 2017 ESICM clinical practice guideline for adult acute respiratory distress syndrome, including COVID-19-related ARDS.
5
The guideline uses systematic-review methods aligned with PRISMA and grades evidence certainty and recommendations using GRADE.
Research Object
adult patients with acute respiratory distress syndrome (ARDS), including COVID-19-related ARDS
Research Subject
the definition, phenotyping, and non-pharmacological respiratory support strategies for ARDS
Publication Details
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2023-06-16
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