Acute Respiratory Distress Syndrome (ARDS) - Management ...
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Acute Respiratory Distress Syndrome (ARDS) - Management Algorithm

Berlin Definition for ARDS & Management Summary

1) Onset within 1 week of insult (usually 72 hours)

2) Not primarily due to hydrostatic edema

3) Imaging showing bilateral opacities on CXR

Mild ARDS:

 - PaO2/FiO2 (P:F) 200-300 mmHg w/ PEEP > 5 cm H2O

 - Mortality: 27%

Moderate ARDS:

 - P:F 100-200 mmHg w/ PEEP > 5 cm H2O

 - Mortality: 32%

Severe ARDS:

 - P:F < 100 mmHg w/ PEEP > 5 cm H2O

 - Mortality: 45%

Controlled Mechanical Ventilation:

 - Target tidal volume 6cc/kg predicted body weight (PBW) and Pplat < 30 cm H2O

 - Consider higher PEEP in moderate and severe ARDS

 - Keep PaO2 55-80 mmHg or SpO2 88-95% with pH > 7.25

Is P:F < 150 mmHg?

1) Sedate and prone

2) Consider paralysis

3) Lung recruitment maneuvers



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