Full-text of the article is available for this locale: Russian.
Abstract
Acute respiratory distress syndrome (ARDS) is one of the most common causes of acute respiratory failure. The updated clinical guidelines are devoted to the state-of-the-art diagnostic approach and treatment of acute respiratory distress syndrome. In the updated version of the clinical guidelines, ARDS diagnostics could be performed not only in intubated but also in non-intubated patients. The approach to the choice of diagnostic methods, intensive care and respiratory support is based on pathophysiology, data from observational and randomized studies on the problem of ARDS. Particular emphasis in the updated version of the clinical guidelines is placed on new data on the features of the clinical course, diagnosis and intensive care for various pathophysiological and clinical phenotypes of ARDS. Data on the use of non-invasive ventilation and high-flow oxygen therapy through nasal cannula in patients with ARDS have been significantly expanded. The recommendations were prepared using studies whose design corresponded to the thesis of the clinical recommendation, as well as systematic reviews and meta-analyses of randomized and non-randomized studies whose design corresponded to the thesis of the clinical recommendation. Based on the presented analysis, recommendations were given for the diagnosis and treatment of acute respiratory distress syndrome, indicating the level of evidence and class of recommendations. The updated clinical recommendations significantly expanded the section on physical activation and rehabilitation of patients with ARDS. The clinical recommendations are intended for anesthesiologists and intensivists, as well as other clinical specialties.
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