February 20, 2018

Michael D. Howell, Andrew M. Davis

JAMA. 2018;319(7):711-712. doi:10.1001/jama.2018.0307

Guideline title 指南标题

Mechanical Ventilation in Adult Patients With Acute Respiratory Distress Syndrome

成年ARDS患者机械通气

Developer 指南制定者

American Thoracic Society (ATS)/European Society of Intensive Care Medicine (ESICM)/Society of Critical Care Medicine (SCCM)

美国胸科学会(ATS)/欧洲重症医学会(ESICM)/美国重症医学会(SCCM)

Release date 发布日期

May 1, 2017

2017年5月1日

Target population 目标人群

Hospitalized adults with acute respiratory distress syndrome (ARDS).

成年ARDS住院患者

Selected major recommendations 主要推荐意见

For all patients with ARDS: 对于所有ARDS患者

• Use lower tidal volumes of 4 to 8 mL/kg per breath, calculated using predicted body weight (PBW) (strong recommendation; moderate confidence in effect estimate). 采用小潮气量4-8 ml/kg，根据理想体重(PBW)进行计算（强推荐；疗效预期中等可靠）

• Use lower inspiratory pressures, targeting a plateau pressure <30 cm H₂O (strong recommendation; moderate confidence). 采用较低的吸气压力，平台压<30 cm H₂O（强推荐；疗效预期中等可靠）

For patients with severe ARDS (Pao₂/Fio₂ ratio <100): 对于严重ARDS患者(Pao₂/Fio₂ ratio <100)

• Use prone positioning for at least 12 h/d (strong recommendation; moderate confidence). 采用俯卧位通气至少每天12小时（强推荐；疗效预期中等可靠）

• Do not routinely use high-frequency oscillatory ventilation (strong recommendation; high confidence). 不应常规使用高频振荡通气（强推荐；疗效预期高度可靠）

• Additional evidence is needed to recommend for or against the use of extracorporeal membrane oxygenation (ECMO) in severe ARDS. 需要更多证据推荐或反对严重ARDS患者使用ECMO