The clinical practice guideline for the management of ARDS in Japan

ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine

Research output: Contribution to journalArticle

10 Citations (Scopus)

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.

Original languageEnglish
Article number50
JournalJournal of Intensive Care
Volume5
Issue number1
DOIs
Publication statusPublished - Jul 25 2017
Externally publishedYes

Fingerprint

Practice Management
Practice Guidelines
Japan
lisofylline
Artificial Respiration
Secretory Proteinase Inhibitory Proteins
Guidelines
Neuromuscular Blocking Agents
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Pressure
Pulmonary Medicine
Ketoconazole
Tokyo
Alprostadil
Tracheostomy
Tidal Volume
Methylprednisolone
Acetylcysteine
Mechanical Ventilators
Critical Care

Keywords

  • Acute lung injury
  • ARDS
  • Clinical practice guideline
  • Systematic review

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine (2017). The clinical practice guideline for the management of ARDS in Japan. Journal of Intensive Care, 5(1), [50]. https://doi.org/10.1186/s40560-017-0222-3

The clinical practice guideline for the management of ARDS in Japan. / ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine.

In: Journal of Intensive Care, Vol. 5, No. 1, 50, 25.07.2017.

Research output: Contribution to journalArticle

ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine 2017, 'The clinical practice guideline for the management of ARDS in Japan', Journal of Intensive Care, vol. 5, no. 1, 50. https://doi.org/10.1186/s40560-017-0222-3
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. 2017 Jul 25;5(1). 50. https://doi.org/10.1186/s40560-017-0222-3
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. In: Journal of Intensive Care. 2017 ; Vol. 5, No. 1.
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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.",
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T1 - The clinical practice guideline for the management of ARDS in Japan

AU - ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine

AU - Hashimoto, Satoru

AU - Sanui, Masamitsu

AU - Egi, Moritoki

AU - Ohshimo, Shinichiro

AU - Shiotsuka, Junji

AU - Seo, Ryutaro

AU - Tanaka, Ryoma

AU - Tanaka, Yu

AU - Norisue, Yasuhiro

AU - Hayashi, Yoshiro

AU - Nango, Eishu

AU - Yasuda, Hideto

AU - Aoki, Yoshitaka

AU - Andoh, Kohkichi

AU - Iizuka, Yusuke

AU - Imaizumi, Hitoshi

AU - Okamori, Satoshi

AU - Kainuma, Motoshi

AU - Kataoka, Jun

AU - Kamo, Tetsuro

AU - Kawaguchi, Atsushi

AU - Kumasawa, Junji

AU - Kurahashi, Kiyoyasu

AU - Kooguchi, Kunihiko

AU - Kondo, Yutaka

AU - Sakuraya, Masaaki

AU - Shimoyama, Akira

AU - Suzuki, So

AU - Suzuki, Hiroyuki

AU - Sekino, Motohiro

AU - Nakajima, Mikio

AU - Nishimura, Tetsuro

AU - Fukuda, Tatsuma

AU - Makino, Jun

AU - Miyashita, Ryoichi

AU - Moriwaki, Ryutaro

AU - Yoshitake, Shigenori

AU - Yamashita, Yumi

AU - Nakagawa, Yoshiko

AU - Suzuki, Takaaki

AU - Aokage, Toshiyuki

AU - Tajimi, Kimitaka

AU - Yuasa, Hidemichi

AU - Imanaka, Hideaki

AU - Ichikado, Kazuya

AU - Nozaki, Ayumu

AU - Kozu, Ryo

AU - Unoki, Takeshi

AU - Takahashi, Yoshinori

AU - Serita, Akimichi

PY - 2017/7/25

Y1 - 2017/7/25

N2 - 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.

AB - 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.

KW - Acute lung injury

KW - ARDS

KW - Clinical practice guideline

KW - Systematic review

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