February 20, 2018
Michael D. Howell, Andrew M. Davis
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
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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)
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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)
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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)
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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)
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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