Ventilação mecânica na síndrome da angústia respiratória aguda: impacto da utilização de volume corrente baixo

Kairalla, Ronaldo Adib; Franca, Suelene Aires

doi:10.1590/s0104-42302000000400014

Cited by 2 publications

(1 citation statement)

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“…In this circumstance, the ARDS Network study, the most remarkable clinical study related to the clinical effect of low tidal volume ventilation, was reported 24 . The study was conducted in 10 institutions in the United States for three years on a large scale.…”

Section: Resultsmentioning

confidence: 99%

Clinical Practice Guideline of Acute Respiratory Distress Syndrome

et al. 2016

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There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

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Section: Resultsmentioning

confidence: 99%