JAMA Clinical Reviews

Acute Respiratory Distress Syndrome: 2023 Guidelines

18 snips
Jul 25, 2023
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INSIGHT

ARDS Is A Biomechanical Syndrome

  • ARDS is a biomechanical syndrome of noncardiogenic pulmonary edema caused by lung injury and impaired oxygenation.
  • Current bedside diagnostic criteria are pragmatic but partly arbitrary and need updating.
ADVICE

Broaden Diagnosis To Include Nonintubated Patients

  • Use the broader term "acute hypoxemic respiratory failure" to include non-intubated patients when considering management strategies.
  • This enables evaluating pre-intubation interventions and care where ventilators are unavailable.
ADVICE

Favor Low Tidal Volumes And Measured PEEP

  • Use low tidal volumes (~6 mL/kg ideal body weight) and avoid unnecessarily high PEEP.
  • Give enough PEEP to maintain oxygenation but reduce it when oxygenation improves to avoid cardiovascular compromise.
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