Full-Text Search:
Home|Journal Papers|About CNKI|User Service|FAQ|Contact Us|中文
《Chinese Critical Care Medicine》 2006-12
Add to Favorite Get Latest Update

Guidelines for management of acute lung injury/acute respiratory distress syndrome: an evidence-based update by the Chinese Society of Critical Care Medicine (2006) Chinese Society of Critical Care Medicine , Chinese Medical Association

Corresponding authors: QIU Hai-bo (Department of Critical Care Medicine, Nanjing Zhongda Hospital, South-East University, Nanjing 210009, Jiangsu, China. ) and LIU Da-wei (Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Medical Science Academy, Beijing 100730, China.)  
Objective In 2006, Chinese critical care experts drafted management guidelines for diagnosis and therapy of acute lung injury (ALI) /acute respiratory distress syndrome (ARDS), that would be of practical use for the clinician, and this effort may serve to increase nationwide awareness and to improve the treatment result of ALI/ARDS. Methods The process included a modified Delphi method, a consensus conference, several subsequent smaller meetings of subgroups and key individuals, teleconferences, and electronic based discussion among subgroups and among the entire committee. The modified Delphi methodology used for grading recommendations was derived from a 2001 publication sponsored by the International Sepsis Forum. A systematic review of the literature was undertook, and the reported results were graded into five levels to create recommendation grading from A to E, with a being the highest grade. Results It is essential to control the primary disease in ALI/ARDS. Role of noninvasive positive-pressure ventilation in ALI/ARDS is undefined. Noninvasive positive-pressure ventilation can not be considered in patients with coma, shock and damage of airway clearance. Limitation of end-inspiratory plateau pressure is important in the management of ARDS and may be facilitated by permissive hypercapnia. Recruitment maneuver should be considered to open collapsed lung and improve oxygenation. A minimum amount of positive end-expiratory pressure (PEEP) should be set to prevent atelectasis at end expiration in ARDS. If it is possible, setting the level of PEEP may be guided by measurement of static pulmonary pressure-volume curve . Unless contraindicated, patients with ARDS should be maintained semi-recumbent. Prone positioning should be considered in the patients with severest ARDS. Sedation protocols should be used. Paralysis is not recommended . The limited fluid management strategy is beneficial for ARDS. Corticosteroid is not recommended for ARDS. The role of other drugs is uncertain in ARDS. Conclusion Evidence-based recommendations can be made regarding many aspects of the acute management of ALI/ARDS that will hopefully translate into improved outcomes for the critically ill patient. The guidelines will be updated when some important new knowledge becomes available.
【CateGory Index】: R563.8
Download(CAJ format) Download(PDF format)
CAJViewer7.0 supports all the CNKI file formats; AdobeReader only supports the PDF format.
【References】
Chinese Journal Full-text Database 10 Hits
1 DU Quan-sheng1,LIU Xiu-qing2,BIAN Yao-xin3(1.ICU,Hebei General Hospital,Shijiazhuang Hebei 050051,China;2.Tangshan Kaiping District Hopsital,Tangshan Hebei 063021,China;3.Hebei Privilege Hospital,Shijiazhuang Hebei 050000,China);Study of sigh treatment on patients with acute lung injury[J];Journal of Hebei University of Science and Technology;2010-06
2 ;肺结核并发急性呼吸窘迫综合征的临床分析[J];Journal of Clinical Pulmonary Medicine;2011-02
3 Han Meiling, Wu Xiaosheng, Han Weizhi;Nursing care of patients with severe phosgene poisoning complicated with ARDS[J];Journal of Nursing Science;2011-15
4 QIN Zong-he,YING You-guo,MAO Yong(Intensive Care Unit,The Third People's Hospital,Institute of Traumatic Medicine,Shanghai Jiaotong University School of Medicine,Shanghai201900,China);Effects of adaptive support ventilation plus lung recruitment maneuvers on acute respiratory distress syndrome[J];Journal of Shanghai Jiaotong University(Medical Science);2010-12
5 LI Ang,WANG Hai-man,YIN Cheng-hong,WANG Chao,DUAN Mei-li,ZHANG Shu-wen.Department of Critical Care Medicine,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China;Epidemiology of acute respiratory distress syndrome in the patients with multiple organ dysfunction syndrome in China:Analyse of the 1087 MODS patients with the multi-centered,prospective method[J];Chinese Journal of Practical Internal Medicine;2009-11
6 Du Yuan,Shi Bing-yi,Qian Ye-yong,Bai Hong-wei,Chang Jing-yuan,Jia Jin-feng,Fan Yu,Ouyang Yun Organ Transplantation Center,Second Affili-ated Hospital,General Hospital of Chinese PLA,Beijing 100091,China;Retrospective analysis of severe pulmonary infection after kidney transplantation in 45 cases[J];Journal of Clinical Rehabilitative Tissue Engineering Research;2008-05
7 ZHANG Yasheng;VENTILATION IN THE THERAPY OF ACUTE RESPIRATORY DISTRESS SYNDROME[J];Modern Hospital;2010-10
8 LIU Xi,CHENG Mei-hua,JIANG Fan,et al(Department of Pediatric,Shenzhen Baoan Maternal and Child Health Hospital,Shenzhen Guangdong 518000,China);Change and Significance of Angiopoietin in Children with Sepsis-related Lung Injury[J];Journal of Xianning University(Medical Sciences);2011-02
9 Zhao-Xin Lu,Cui-Cui Gao,Clinical College,Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong Province,ChinaMing Zhang,Zhong-Hui Zhang,Zhi-Ming Jiang,Jun Yang,Yong-Qing Xu,Tao Li,Jian Xie,Intensive Care Unit,Qianfoshan Hospital of Shandong Province,Jinan 250014,Shandong Province,China;Effect of Yiqi Tongfu Zhuyu decoction enema therapy on intestinal mucosal barrier function in patients with sepsis[J];World Chinese Journal of Digestology;2009-24
10 ZHI Shao-ce,LU Zhong-qiu,LIU Gang,JIN Xiao;Mechanical ventilation in the patients with acute respiratory distress syndrome caused by irritative gas[J];China Occupational Medicine;2008-02
【Co-references】
Chinese Journal Full-text Database 10 Hits
1 LIU Li-Xia, HU Zhen-Jie, ZHAO Chai Intensive Care Unit,The Forth Affiliated Hospital,Hebei Medical University,Shijiazhuang, Hebei, 050011,P. R. China;Correlations of Preoperative Pulmonary Function Tests for Esophageal Cancer to Postoperative Acute Respiratory Distress Syndrome[J];Chinese Journal of Cancer;2006-03
2 Gu Jianzhong, Ye Jing, Zhang Yuan, et al Zhejiang College of TCM,Hangzhou (310053);The Effect of Dachengqi Decoction On The ARDS Rat’s Blood Coagulation System and Platelet[J];;2006-01
3 OU Shu-qin,MA Yu,WEN Yu-ming,et al.(ICU,Chongqing Emergency Medical Centre,Chongqing 400014,China);Clinical study on therapy of acute respiratory distress syndrome with ulinastatin[J];Chongqing Medicine;2008-12
4 JIAN Hua-sheng,YU Chang-qing (Emergency Department,Daping Hospital,Third Military Medical University,Chongqing 400042,China);Present status and advances of mechanical ventilation in acute lung injury[J];Journal of Traumatic Surgery;2005-03
5 YU Chen-bin,SUN Hai-chen ( Nanjing General Hospital of Nanjing Military Command,School of Medicine,Nanjing University,Nanjing 210002,China);Potentiality in treatment of acute lung injury with penehyclidine hydrochloride[J];Journal of Traumatic Surgery;2007-01
6 YU Chen-bin,SUN Hai-chen,NIE Shi-nan,et al.(Department of Emergency Medicine,Nanjing General Hospital of Nanjing Military Command,School of Medicine,Nanjing University,Nanjing 21002,China);Penehyclidine hydrochloride for early treatment of traumatic acute lung injury[J];Journal of Traumatic Surgery;2007-04
7 DU Quan,WANG Zheng-guo,ZHU Pei-fang,et al.(State Key Laboratory of Trauma,Burns and Combined Injury,Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing 400042,China);Gene expression and receptor reactivity of Toll-like receptor 2 and 4 on macrophages after trauma in rats[J];Journal of Traumatic Surgery;2008-05
8 TAN Zhao-hua,XU Jun-mei, YANG Zhao-yun,et al. Department of Anesthesiology, The Second Xiangya Hospital, Central South University,changsha 410011,China;The Effects of Ulinastatin on Proinflammatory Cytokine and Oxygen Free Radicals During Acute Lung Injury in Rabbits[J];Journal of Chinese Physician;2004-10
9 HOU Yi feng, MAO Bao ling, QIAN Gui sheng, XU Jian cheng (Institute of Respiratory Diseases of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China);Expression of lipopolysaccharide binding protein mRNA in pulmonary tissues of rat with ‘two-hit’ acute lung injury and the protective effects of anisodamine in this event[J];Acta Academiae Medicine Militaris Tertiae;2001-07
10 ZHANG Qing, MAO Bao ling, QIAN Gui sheng, LI Qi, CHEN Zheng tang, XU Jian cheng (Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China);Changes of TNF-α, IL-1β, and IL-6 levels in plasma and bronchoalveolar lavage fluid of rats after seguential injury with oleic acid and lipopolysaccharide[J];Acta Academiae Medicinae Militaris Tertiae;2004-15
【Secondary References】
Chinese Journal Full-text Database 7 Hits
1 Wang Hongyou,Hu Yufeng,Zhou Shusheng,et alDepartment of ICU,Maanshan People's Hospital,Maanshan 243000,China;Clinic study on Xuebijing injection in treatment of patients with acute lung injure/acute respiratory distress syndrome[J];Anhui Medical Journal;2011-06
2 WANG Lin-lin, CHEN Xiu-qi (Department of Pediatrics, The First Hospital Affiliated to Guangxi Medical College, Nanning 530021, Guangxi, China);The intestinal-liver barrier defense and endotoxin translocation[J];Journal of Clinical Pediatrics;2010-10
3 HUANG Daoyong,CHEN Mao,LIN Kaixuan;ANALYSIS OF THE REASON INDUCED HUMAN-MACHINE COUNTERWORK IN PATIENTS USING MECHANICAL VENTILATION AND THE STRATEGY TO MANAGE IT[J];Modern Hospital;2011-03
4 WANG Shao-hua,RUAN Zheng,ZHENG Jian,HUANG Hai-long,SONG Kang-sheng.(Department of Thoracic Surgery,the First People’s Hospital,Shanghai Jiaotong University,Shanghai 200080,P.R.China;);Analysis of Risk Factors of Pulmonary Complications Following Lung Resection[J];Chinese Journal of Clinical Thoracic and Cardiovascular Surgery;2010-04
5 HUANG Chaolin,NI Zhengyi,ZHOU Mi,XU Jun Wuhan Medical Treatment Center,Wuhan 430023,China;The treatment experience of 28 cases acute respiratory distress syndrome after pulmonary lobectomies[J];China Medical Herald;2011-14
6 Huang Yun, Zhan Feng, Lin Shu-dian, Chen Dao-jun, Li Wen-ning Department of Nephrology, Hainan Provincial People’s Hospital, Haikou 570311, Hainan Province, China;Immunoglobulin prevents pneumonia in patients with decreased T lymphocytes after renal transplantation[J];Journal of Clinical Rehabilitative Tissue Engineering Research;2011-18
7 ZHANG Xiao-diao.(The Third Affiliated Hospital,Wenzhou Medical College,Ruian 325200,China);SERUM AND BRONCHOALVEOLAR LAVAGE FLUID CYTOKINES IN ACUTE RESPIRATORY DISTRESS SYNDROME IN THE SENSE[J];Modern Preventive Medicine;2011-16
©2006 Tsinghua Tongfang Knowledge Network Technology Co., Ltd.(Beijing)(TTKN) All rights reserved