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Comparing ATS and ESICM ARDS Guidelines Recommendations
The difference between the ATS and ESICM ARDS guidelines recommendations lies in the approach towards deep sedation and neuromuscular blockade. The ATS guidelines suggest deep sedation for severe ARDS patients based on a mortality benefit, while the ESICM guidelines recommend against deep sedation due to its association with neuromuscular blockade. In terms of peep and recruitment maneuvers, ATS recommends a higher peep without lung recruitment maneuvers for moderate to severe ARDS, while ESICM makes no formal recommendation on these practices. Recruitment maneuvers, involving high pressure to recruit atelectatic lung areas, were popular in the past but were abandoned due to adverse effects like hypotension and peri-arrests.