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Open Access 06-05-2024 | Acute Respiratory Distress-Syndrome | Editorial

Definitions, guidelines and opinions: the white, the black and the grey

Author: Luciano Gattinoni

Excerpt

Due to demographic reasons, I have had the opportunity to participate in all the international consensus conferences, up to Berlin [1], for the definition of acute respiratory distress syndrome (ARDS) and the development of guidelines for its management. The current tendency is to simplify both the definition and the management approach, primarily focussing on oxygenation or haemoglobin oxygen saturation [2], whilst other physiological variables, as respiratory mechanics or haemodynamics, are downplayed or ignored. It is, therefore, worthwhile to question the real value of guidelines in defining and managing ARDS, especially today when two leading societies have issued markedly different recommendations for three key aspects: positive end-expiratory pressure (PEEP) selection, venovenous extracorporeal membrane oxygenation (VV-ECMO) indications, and use of neuromuscular blockade [3, 4]. Before addressing these issues, it is crucial to reflect on the value of guidelines in managing syndromes such as ARDS, which is a collection of signs and symptoms with various causes and not a single disease. …

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Title: Definitions, guidelines and opinions: the white, the black and the grey
Author: Luciano Gattinoni
Publication date: 06-05-2024
Publisher: Springer Berlin Heidelberg
Keywords: Acute Respiratory Distress-Syndrome
ECMO
ECMO
Published in: Intensive Care Medicine
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-024-07410-x

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