The clinical practice guideline for the management of ARDS in Japan
Abstract Background The Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine provide here a clinical practice guideline for the management of adult patients with ARDS in the ICU. Method The guideline was developed applying the GRADE system for performing...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | Journal of Intensive Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40560-017-0222-3 |
| _version_ | 1828266675766558720 |
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| author | Satoru Hashimoto Masamitsu Sanui Moritoki Egi Shinichiro Ohshimo Junji Shiotsuka Ryutaro Seo Ryoma Tanaka Yu Tanaka Yasuhiro Norisue Yoshiro Hayashi Eishu Nango ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine |
| author_facet | Satoru Hashimoto Masamitsu Sanui Moritoki Egi Shinichiro Ohshimo Junji Shiotsuka Ryutaro Seo Ryoma Tanaka Yu Tanaka Yasuhiro Norisue Yoshiro Hayashi Eishu Nango ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine |
| author_sort | Satoru Hashimoto |
| collection | DOAJ |
| description | Abstract Background The Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine provide here a clinical practice guideline for the management of adult patients with ARDS in the ICU. Method The guideline was developed applying the GRADE system for performing robust systematic reviews with plausible recommendations. The guideline consists of 13 clinical questions mainly regarding ventilator settings and drug therapies (the last question includes 11 medications that are not approved for clinical use in Japan). Results The recommendations for adult patients with ARDS include: we suggest against early tracheostomy (GRADE 2C), we suggest using NPPV for early respiratory management (GRADE 2C), we recommend the use of low tidal volumes at 6-8 mL/kg (GRADE 1B), we suggest setting the plateau pressure at 30cmH20 or less (GRADE2B), we suggest using PEEP within the range of plateau pressures less than or equal to 30cmH2O, without compromising hemodynamics (Grade 2B), and using higher PEEP levels in patients with moderate to severe ARDS (Grade 2B), we suggest using protocolized methods for liberation from mechanical ventilation (Grade 2D), we suggest prone positioning especially in patients with moderate to severe respiratory dysfunction (GRADE 2C), we suggest against the use of high frequency oscillation (GRADE 2C), we suggest the use of neuromuscular blocking agents in patients requiring mechanical ventilation under certain circumstances (GRADE 2B), we suggest fluid restriction in the management of ARDS (GRADE 2A), we do not suggest the use of neutrophil elastase inhibitors (GRADE 2D), we suggest the administration of steroids, equivalent to methylprednisolone 1-2mg/kg/ day (GRADE 2A), and we do not recommend other medications for the treatment of adult patients with ARDS (GRADE1B; inhaled/intravenous β2 stimulants, prostaglandin E1, activated protein C, ketoconazole, and lisofylline, GRADE 1C; inhaled nitric oxide, GRADE 1D; surfactant, GRADE 2B; granulocyte macrophage colony-stimulating factor, N-acetylcysteine, GRADE 2C; Statin.) Conclusions This article was translated from the Japanese version originally published as the ARDS clinical practice guidelines 2016 by the committee of ARDS clinical practice guideline (Tokyo, 2016, 293p, available from http://www.jsicm.org/ARDSGL/ARDSGL2016.pdf ). The original article, written for Japanese healthcare providers, provides points of view that are different from those in other countries. |
| first_indexed | 2024-04-13T04:56:30Z |
| format | Article |
| id | doaj.art-cbe2a93ab9df4d4d9786cb8d00255f9e |
| institution | Directory Open Access Journal |
| issn | 2052-0492 |
| language | English |
| last_indexed | 2024-04-13T04:56:30Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Intensive Care |
| spelling | doaj.art-cbe2a93ab9df4d4d9786cb8d00255f9e2022-12-22T03:01:29ZengBMCJournal of Intensive Care2052-04922017-07-015113210.1186/s40560-017-0222-3The clinical practice guideline for the management of ARDS in JapanSatoru Hashimoto0Masamitsu Sanui1Moritoki Egi2Shinichiro Ohshimo3Junji Shiotsuka4Ryutaro Seo5Ryoma Tanaka6Yu Tanaka7Yasuhiro Norisue8Yoshiro Hayashi9Eishu Nango10ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care MedicineDepartment of Anesthesiology and Intensive Care, Kyoto Prefectural University of MedicineDepartment of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical CenterDepartment of anesthesiology, Kobe University HospitalDepartment of Emergency and Critical Care Medicine, Hiroshima UniversityDivision of Critical Care Medicine, Okinawa Chubu HospitalDepartment of Emergency Medicine, Kobe City Medical Center General HospitalPulmonary & Critical Care Medicine, LDS HospitalDepartment of Anesthesiology, Nara Medical UniversityDepartment of Emergency and Critical Care Medicine, Tokyo Bay Medical CenterDepartment of Intensive Care Medicine, Kameda Medical CenterDepartment of General Medicine, Tokyo kita Social Insurance HospitalAbstract Background The Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine provide here a clinical practice guideline for the management of adult patients with ARDS in the ICU. Method The guideline was developed applying the GRADE system for performing robust systematic reviews with plausible recommendations. The guideline consists of 13 clinical questions mainly regarding ventilator settings and drug therapies (the last question includes 11 medications that are not approved for clinical use in Japan). Results The recommendations for adult patients with ARDS include: we suggest against early tracheostomy (GRADE 2C), we suggest using NPPV for early respiratory management (GRADE 2C), we recommend the use of low tidal volumes at 6-8 mL/kg (GRADE 1B), we suggest setting the plateau pressure at 30cmH20 or less (GRADE2B), we suggest using PEEP within the range of plateau pressures less than or equal to 30cmH2O, without compromising hemodynamics (Grade 2B), and using higher PEEP levels in patients with moderate to severe ARDS (Grade 2B), we suggest using protocolized methods for liberation from mechanical ventilation (Grade 2D), we suggest prone positioning especially in patients with moderate to severe respiratory dysfunction (GRADE 2C), we suggest against the use of high frequency oscillation (GRADE 2C), we suggest the use of neuromuscular blocking agents in patients requiring mechanical ventilation under certain circumstances (GRADE 2B), we suggest fluid restriction in the management of ARDS (GRADE 2A), we do not suggest the use of neutrophil elastase inhibitors (GRADE 2D), we suggest the administration of steroids, equivalent to methylprednisolone 1-2mg/kg/ day (GRADE 2A), and we do not recommend other medications for the treatment of adult patients with ARDS (GRADE1B; inhaled/intravenous β2 stimulants, prostaglandin E1, activated protein C, ketoconazole, and lisofylline, GRADE 1C; inhaled nitric oxide, GRADE 1D; surfactant, GRADE 2B; granulocyte macrophage colony-stimulating factor, N-acetylcysteine, GRADE 2C; Statin.) Conclusions This article was translated from the Japanese version originally published as the ARDS clinical practice guidelines 2016 by the committee of ARDS clinical practice guideline (Tokyo, 2016, 293p, available from http://www.jsicm.org/ARDSGL/ARDSGL2016.pdf ). The original article, written for Japanese healthcare providers, provides points of view that are different from those in other countries.http://link.springer.com/article/10.1186/s40560-017-0222-3ARDSAcute lung injurysystematic reviewclinical practice guideline |
| spellingShingle | Satoru Hashimoto Masamitsu Sanui Moritoki Egi Shinichiro Ohshimo Junji Shiotsuka Ryutaro Seo Ryoma Tanaka Yu Tanaka Yasuhiro Norisue Yoshiro Hayashi Eishu Nango ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine The clinical practice guideline for the management of ARDS in Japan Journal of Intensive Care ARDS Acute lung injury systematic review clinical practice guideline |
| title | The clinical practice guideline for the management of ARDS in Japan |
| title_full | The clinical practice guideline for the management of ARDS in Japan |
| title_fullStr | The clinical practice guideline for the management of ARDS in Japan |
| title_full_unstemmed | The clinical practice guideline for the management of ARDS in Japan |
| title_short | The clinical practice guideline for the management of ARDS in Japan |
| title_sort | clinical practice guideline for the management of ards in japan |
| topic | ARDS Acute lung injury systematic review clinical practice guideline |
| url | http://link.springer.com/article/10.1186/s40560-017-0222-3 |
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