Act fast and ventilate soft: the Düsseldorf hands-on translation of the acute respiratory distress syndrome Berlin definition

J Crit Care. 2014 Oct;29(5):883.e1-5. doi: 10.1016/j.jcrc.2014.03.024. Epub 2014 Apr 2.

Abstract

Early identification of acute respiratory distress syndrome (ARDS) and forceful implementation of standardized therapy algorithms are the mandatory basis of an effective therapy to improve patient outcome. Recently, a new definition of ARDS was implemented, which simplified the diagnostic criteria for ARDS. Evidence-based therapies are rare, but some cornerstone interventions can be recommended. Lung-protective ventilation with high positive end-expiratory pressure and low tidal volume and early prone positioning in severe cases improve survival rate. We here present an integrated "Düsseldorf hands-on translation" in the form of a "one-page" standard operating procedure in order to fasten and standardize both diagnosis and therapeutic algorithms on an intensive care unit.

Keywords: ARDS; Berlin definition; PEEP; Prone position.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Berlin
  • Blood Gas Analysis
  • Energy Intake
  • Extracorporeal Membrane Oxygenation / standards
  • Humans
  • Intensive Care Units
  • Nitric Oxide / administration & dosage
  • Nutritional Support / standards
  • Patient Positioning / mortality
  • Positive-Pressure Respiration / methods
  • Prone Position
  • Respiration, Artificial / methods
  • Respiration, Artificial / mortality
  • Respiratory Distress Syndrome / diagnosis*
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / therapy*
  • Tidal Volume

Substances

  • Anti-Bacterial Agents
  • Nitric Oxide