An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome

Imagem de Miniatura
Arquivos
art_FAN_An_Official_American_Thoracic_SocietyEuropean_Society_of_Intensive_2017.PDF (584.93 KB)
Citações na Scopus
1067
Tipo de produção
article
Data de publicação
2017
Editora
AMER THORACIC SOC
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
FAN, Eddy
SORBO, Lorenzo Del
GOLIGHER, Ewan C.
HODGSON, Carol L.
MUNSHI, Laveena
WALKEY, Allan J.
ADHIKARI, Neill K. J.
BRANSON, Richard
BROWER, Roy G.
Autor de Grupo de pesquisa
Amer Thoracic Soc
European Soc Intensive Care Med
Soc Critical Care Med
Editores
Coordenadores
Organizadores
Citação
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, v.195, n.9, p.1253-1263, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: This document provides evidence-based clinical practice guidelines on the use of mechanical ventilation in adult patients with acute respiratory distress syndrome (ARDS). Methods: A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations. Results: For all patients with ARDS, the recommendation is strong for mechanical ventilation using lower tidal volumes (4-8 ml/kg predicted bodyweight) and lower inspiratory pressures (plateau pressure < 30 cm H2O) (moderate confidence in effect estimates). For patients with severe ARDS, the recommendation is strong for prone positioning for more than 12 h/d (moderate confidence in effect estimates). For patients with moderate or severeARDS, the recommendation is strong against routine use of high-frequency oscillatory ventilation (high confidence in effect estimates) and conditional for higher positive end-expiratory pressure (moderate confidence in effect estimates) and recruitment maneuvers (low confidence in effect estimates). Additional evidence is necessary to make a definitive recommendation for or against the use of extracorporeal membrane oxygenation in patients with severe ARDS. Conclusions: The panel formulated and provided the rationale for recommendations on selected ventilatory interventions for adult patients with ARDS. Clinicians managing patients with ARDS should personalize decisions for their patients, particularly regarding the conditional recommendations in this guideline.
Palavras-chave
URI
https://observatorio.fm.usp.br/handle/OPI/21265
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Artigos e Materiais de Revistas Científicas - FM/MCP
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