Sadatomo Tasaka1, Shinichiro Ohshimo2, Muneyuki Takeuchi3, Hideto Yasuda4, Kazuya Ichikado5, Kenji Tsushima6, Moritoki Egi7, Satoru Hashimoto8, Nobuaki Shime2, Osamu Saito9, Shotaro Matsumoto10, Eishu Nango11, Yohei Okada12, Kenichiro Hayashi13, Masaaki Sakuraya14, Mikio Nakajima15, Satoshi Okamori16, Shinya Miura17, Tatsuma Fukuda18, Tadashi Ishihara19, Tetsuro Kamo20, Tomoaki Yatabe21, Yasuhiro Norisue22, Yoshitaka Aoki23, Yusuke Iizuka24, Yutaka Kondo25, Chihiro Narita26, Daisuke Kawakami27, Hiromu Okano28, Jun Takeshita29, Keisuke Anan30, Satoru Robert Okazaki31, Shunsuke Taito32, Takuya Hayashi33, Takuya Mayumi34, Takero Terayama35, Yoshifumi Kubota36, Yoshinobu Abe37, Yudai Iwasaki38, Yuki Kishihara39, Jun Kataoka40, Tetsuro Nishimura41, Hiroshi Yonekura42, Koichi Ando43, Takuo Yoshida44, Tomoyuki Masuyama45, Masamitsu Sanui24. 1. Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan. tasaka@hirosaki-u.ac.jp. 2. Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. 3. Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, Osaka, Japan. 4. Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan. 5. Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan. 6. International University of Health and Welfare, Tokyo, Japan. 7. Department of Anesthesiology, Kobe University Hospital, Hyogo, Japan. 8. Department of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan. 9. Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 10. Division of Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan. 11. Department of Family Medicine, Seibo International Catholic Hospital, Tokyo, Japan. 12. Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 13. Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan. 14. Department of Emergency and Intensive Care Medicine, JA Hiroshima General Hospital, Hiroshima, Japan. 15. Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan. 16. Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan. 17. Paediatric Intensive Care Unit, The Royal Children's Hospital, Melbourne, Australia. 18. Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. 19. Department of Emergency and Critical Care Medicine, Urayasu Hospital, Juntendo University, Chiba, Japan. 20. Department of Critical Care Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan. 21. Department of Anesthesiology, Nishichita General Hospital, Tokai, Japan. 22. Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan. 23. Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan. 24. Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan. 25. Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba, Japan. 26. Department of Emergency Medicine, Shizuoka General Hospital, Shizuoka, Japan. 27. Department of Anesthesia and Critical Care, Kobe City Medical Center General Hospital, Hyogo, Japan. 28. Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. 29. Department of Anesthesiology, Osaka Women's and Children's Hospital, Osaka, Japan. 30. Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kyoto, Japan. 31. Department of Intensive Care Medicine, Kameda Medical Center, Chiba, Japan. 32. Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan. 33. Pediatric Emergency and Critical Care Center, Saitama Children's Medical Center, Saitama, Japan. 34. Department of Cardiovascular Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. 35. Department of Psychiatry, School of Medicine, National Defense Medical College, Saitama, Japan. 36. Kameda Medical Center Department of Infectious Diseases, Chiba, Japan. 37. Division of Emergency and Disaster Medicine Tohoku Medical and Pharmaceutical University, Miyagi, Japan. 38. Department of Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan. 39. Department of Emergency Medicine, Japanese Red Cross Musashino Hospital, Tokyo, Japan. 40. Department of Critical Care Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan. 41. Department of Traumatology and Critical Care Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. 42. Department of Anesthesiology and Pain Medicine, Fujita Health University Bantane Hospital, Aichi, Japan. 43. Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan. 44. Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan. 45. Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan.
Abstract
BACKGROUND: The joint committee of the Japanese Society of Intensive Care Medicine/Japanese Respiratory Society/Japanese Society of Respiratory Care Medicine on ARDS Clinical Practice Guideline has created and released the ARDS Clinical Practice Guideline 2021. METHODS: The 2016 edition of the Clinical Practice Guideline covered clinical questions (CQs) that targeted only adults, but the present guideline includes 15 CQs for children in addition to 46 CQs for adults. As with the previous edition, we used a systematic review method with the Grading of Recommendations Assessment Development and Evaluation (GRADE) system as well as a degree of recommendation determination method. We also conducted systematic reviews that used meta-analyses of diagnostic accuracy and network meta-analyses as a new method. RESULTS: Recommendations for adult patients with ARDS are described: we suggest against using serum C-reactive protein and procalcitonin levels to identify bacterial pneumonia as the underlying disease (GRADE 2D); we recommend limiting tidal volume to 4-8 mL/kg for mechanical ventilation (GRADE 1D); we recommend against managements targeting an excessively low SpO2 (PaO2) (GRADE 2D); we suggest against using transpulmonary pressure as a routine basis in positive end-expiratory pressure settings (GRADE 2B); we suggest implementing extracorporeal membrane oxygenation for those with severe ARDS (GRADE 2B); we suggest against using high-dose steroids (GRADE 2C); and we recommend using low-dose steroids (GRADE 1B). The recommendations for pediatric patients with ARDS are as follows: we suggest against using non-invasive respiratory support (non-invasive positive pressure ventilation/high-flow nasal cannula oxygen therapy) (GRADE 2D), we suggest placing pediatric patients with moderate ARDS in the prone position (GRADE 2D), we suggest against routinely implementing NO inhalation therapy (GRADE 2C), and we suggest against implementing daily sedation interruption for pediatric patients with respiratory failure (GRADE 2D). CONCLUSIONS: This article is a translated summary of the full version of the ARDS Clinical Practice Guideline 2021 published in Japanese (URL: https://www.jsicm.org/publication/guideline.html ). The original text, which was written for Japanese healthcare professionals, may include different perspectives from healthcare professionals of other countries.
BACKGROUND: The joint committee of the Japanese Society of Intensive Care Medicine/Japanese Respiratory Society/Japanese Society of Respiratory Care Medicine on ARDS Clinical Practice Guideline has created and released the ARDS Clinical Practice Guideline 2021. METHODS: The 2016 edition of the Clinical Practice Guideline covered clinical questions (CQs) that targeted only adults, but the present guideline includes 15 CQs for children in addition to 46 CQs for adults. As with the previous edition, we used a systematic review method with the Grading of Recommendations Assessment Development and Evaluation (GRADE) system as well as a degree of recommendation determination method. We also conducted systematic reviews that used meta-analyses of diagnostic accuracy and network meta-analyses as a new method. RESULTS: Recommendations for adult patients with ARDS are described: we suggest against using serum C-reactive protein and procalcitonin levels to identify bacterial pneumonia as the underlying disease (GRADE 2D); we recommend limiting tidal volume to 4-8 mL/kg for mechanical ventilation (GRADE 1D); we recommend against managements targeting an excessively low SpO2 (PaO2) (GRADE 2D); we suggest against using transpulmonary pressure as a routine basis in positive end-expiratory pressure settings (GRADE 2B); we suggest implementing extracorporeal membrane oxygenation for those with severe ARDS (GRADE 2B); we suggest against using high-dose steroids (GRADE 2C); and we recommend using low-dose steroids (GRADE 1B). The recommendations for pediatric patients with ARDS are as follows: we suggest against using non-invasive respiratory support (non-invasive positive pressure ventilation/high-flow nasal cannula oxygen therapy) (GRADE 2D), we suggest placing pediatric patients with moderate ARDS in the prone position (GRADE 2D), we suggest against routinely implementing NO inhalation therapy (GRADE 2C), and we suggest against implementing daily sedation interruption for pediatric patients with respiratory failure (GRADE 2D). CONCLUSIONS: This article is a translated summary of the full version of the ARDS Clinical Practice Guideline 2021 published in Japanese (URL: https://www.jsicm.org/publication/guideline.html ). The original text, which was written for Japanese healthcare professionals, may include different perspectives from healthcare professionals of other countries.
Authors: Wei Chen; David R Janz; Ciara M Shaver; Gordon R Bernard; Julie A Bastarache; Lorraine B Ware Journal: Chest Date: 2015-12 Impact factor: 9.410
Authors: C Delclaux; E L'Her; C Alberti; J Mancebo; F Abroug; G Conti; C Guérin; F Schortgen; Y Lefort; M Antonelli; E Lepage; F Lemaire; L Brochard Journal: JAMA Date: 2000-11-08 Impact factor: 56.272
Authors: Robert W Taylor; Janice L Zimmerman; R Phillip Dellinger; Richard C Straube; Gerard J Criner; Kenneth Davis; Kathleen M Kelly; Thomas C Smith; Robert J Small Journal: JAMA Date: 2004-04-07 Impact factor: 56.272