Acute Respiratory Distress Syndrome
ICD-10 J80 · ICD-11 CB00

Treatment of Acute Respiratory Distress Syndrome Requiring Mechanical Ventilation

Clinical Scenario

Acute respiratory distress syndrome (ARDS) presents a critical management challenge when the degree of hypoxaemia and respiratory failure necessitates mechanical ventilatory support. In this setting, both the ventilation strategy and fluid management approach are key determinants of outcome.

Treatment Approach (Partial Overview)

When mechanical ventilation is required, the evidence-based approach centres on a lung-protective ventilation strategy — specifically involving tidal volume and airway pressure targets — combined with a deliberate approach to fluid balance using restriction and adjunctive measures.

The complete regimen, including specific parameters, sequencing, and adjuncts, is available in the full structured protocol.
Instant Access to Structured Evidence-Based Regimens
References
  1. Where mechanical ventilation is required, the use of low tidal volumes (<6 ml/kg ideal body weight) and airway pressures (plateau pressure <30 cmH2O) was recommended.
  2. We recommend the routine use of lower tidal volumes for the management of patients with ARDS (GRADE Recommendation: strongly in favour).
  3. We therefore suggest that in adult patients with ARDS, clinicians consider the use of a conservative fluid strategy which uses fluid restriction, diuretics and possibly hyperoncotic albumin to avoid a positive fluid balance in preference to a liberal fluid strategy.
DOI: 10.1136/bmjresp-2019-000420
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