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Crit Care. 2017 Sep 12;21(1):240. doi: 10.1186/s13054-017-1820-0.

Respiratory support in patients with acute respiratory distress syndrome: an expert opinion.

Author information

1
Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.
2
Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
3
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
4
University of Minnesota, Minneapolis, Saint Paul, MN, USA.
5
University of Montreal and Department of Intensive Care, Centre Hospitalier Université de Montréal, Montréal, QC, Canada.
6
Department of Anesthesia and Critical Care Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Viale del Policlinico 155, 00161, Rome, Italy.
7
Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA.
8
Réanimation des Détresses Respiratoires et Infections Sévères, Hôpital Nord-Assistance Publique-Hôpitaux de Marseille Aix-Marseille Université, Marseille, France.
9
Mahidol Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
10
Laboratório de Pneumologia LIM-09, Disciplina de Pneumologia, Heart Institute (InCor) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
11
Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
12
CHU d'Angers, Réanimation Médicale et Médecine Hyperbare, Angers, France.
13
Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
14
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
15
Department of Anesthesia and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
16
Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium. jlvincent@intensive.org.

Abstract

Acute respiratory distress syndrome (ARDS) is a common condition in intensive care unit patients and remains a major concern, with mortality rates of around 30-45% and considerable long-term morbidity. Respiratory support in these patients must be optimized to ensure adequate gas exchange while minimizing the risks of ventilator-induced lung injury. The aim of this expert opinion document is to review the available clinical evidence related to ventilator support and adjuvant therapies in order to provide evidence-based and experience-based clinical recommendations for the management of patients with ARDS.

KEYWORDS:

Esophageal pressure; Extracorporeal membrane oxygenation; Positive end-expiratory pressure; Tidal volume; Ventilator support; Ventilator-induced lung injury; Weaning

PMID:
28899408
PMCID:
PMC5596474
DOI:
10.1186/s13054-017-1820-0
[Indexed for MEDLINE]
Free PMC Article

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