Table 4 Recommendations for acute respiratory distress syndrome in major guidelines: (1) ventilatory management
From: Guideline-based management of acute respiratory failure and acute respiratory distress syndrome
| Â | JRS/JSICM/JSRCM-GL2021 | SSCG 2021 | SRLF-GL 2019 | FICM/ICS- GL 2018 | ATS/ESICM/SCCM-GL2017 | SSAI-ARDS-GL2016 | KSCCM/KATRD-ARDS-GL2016 |
|---|---|---|---|---|---|---|---|
Lower SpO2 (PaO2) target | D for excess control | - |  |  |  | – |  |
HFNC | B | Â | Â | Â | Â | Â | Â |
NPPV | B |  |  |  |  | – |  |
Lung protective ventilation | Â | Â | Â | Â | Â | Â | Â |
 Low tidal volume | A | A | A | A | A | A | A |
 Low plateau pressure | B | A Severe | A |  | A | A | – |
High level PEEP | B | A: Moderate–severe | A | B: P/F ≤ 200 | C: Moderate–severe | B | B |
Recruitment maneuver | D | B: Moderate–severe traditional | E: routine use |  | C | B | B |
Prone position | B: Long hours | A: Moderate–severe,  ≥ 12 h | A: P/F < 150,  ≥ 16 h | A: P/F < 150,  ≥ 12 h | A: ≥ 12 h | B | A |
High-frequency oscillatory ventilation (HFOV) | D | Â | E | E | E | E | E |
Limited muscle relaxants use | B: Moderate–severe | B: Moderate–severe, intermittent use | A: P/F < 150,  ≤ 48 h | B: P/F ≤ 150,  ≤ 48 h |  | B | B |
Weening protocolization | B | Â | Â | Â | Â | Â | Â |
Early tracheotomy | B | Â | Â | Â | Â | Â | D |