Ventilatory management of acute respiratory distress syndrome: a consensus of two.
OBJECTIVE
To synthesize the emerging body of experimental, observational, and clinical trial data into a practical guideline for safe and effective ventilatory management of acute respiratory distress syndrome.


METHODS
Relevant, peer-reviewed, scientific literature and personal observations from clinical practice.


METHODS
Relevant experimental studies and high-impact observational and clinical trials of acute respiratory distress syndrome management.


METHODS
Detailed review of information contained in published scientific work.


RESULTS
Interactive discussions between the authors that culminated in our consensus view of appropriate management.


CONCLUSIONS
Prevention of ventilator-induced lung injury while accomplishing the essential life-supporting roles of mechanical ventilation is a complex undertaking that requires application of principles founded on a broad experimental and clinical database and on the results of well-executed clinical trials. At the bedside, execution of an effective lung-protective ventilation strategy remains an empirical process best guided by integrated physiology and a readiness to revise the management approach depending on the individual's response.
Marini
John J
JJ
University of Minnesota, Regions Hospital, St. Paul 55101, USA. John.j.marini@healthpartners.com
Gattinoni
Luciano
L
D000818:Animals; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012121:Respiration, Artificial / Q000009:adverse effects / Q000592:standards*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome