Critical care education one page at a time. Simple, free, & open source.
Nick Mark’s OnePager guides to critical care topics.
Understanding & Treating ARDS
#criticalCare #ventilators #ARDS #proning
Acute Respiratory Distress Syndrome (ARDS) is one of the most serious and challenging conditions we encounter in the ICU. It’s also one of the life threatening complications of COVID-19. Here’s a #onePager that will help you understand ARDS, including its definition, pathophysiology, and the approach I use for treatment. Hint: just remember the Eight P’s: PEEP (lung protective ventilation), Prone positioning, Paralysis (neuromuscular blockade), Prostacyclins (inhaled vasodilators), Peeing (diuresis), Pleural evacuation (thoracentesis), Peripheral oxygenation (ECMO), and Prednisone (corticosteroids).
Current version 1.1 (originally posted 2020-03-30; last updated 2020-10-01) Also available in Spanish 🇪🇸 (JPEG).
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ARDS: Berlin Definition, JAMA 2012
“Imitators” of the ARDS: Implications for Diagnosis and Treatment, CHEST 2004
ARDSNet Trial, NEJM 2000
FACTT Trial, NEJM 2006
CESAR Trial, Lancet 2009
ACURASYS Trial, NEJM 2010
PROSEVA Trial, NEJM 2013
DEXA-ARDS, Lancet 2020
Utility and safety of draining pleural effusions in mechanically ventilated patients: a systematic review and meta-analysis, Critical Care 2011
The Use of Inhaled Prostaglandins in Patients With ARDS: A Systematic Review and Meta-analysis, CHEST 2015
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Also available in Spanish 🇪🇸 (JPEG).
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Current version 1.1
originally posted 2020-03-30
last updated 2020-10-01)
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Proning Preparation Checklist (from Respiratory Care Journal)
Video Demonstration of Burrito Proning Technique (from Cardiff Critical Care)
The RESP Score (used to calculate mortality for patients with hypoxemic respiratory failure undergoing VV ECMO)
The SAVE-SCORE (used to calculate mortality for patients with cardiogenic shock undergoing VA ECMO)
Other OnePagers Relevant to ARDS
