Table 12

Summary of the FICM/ICS Guidelines for the management of ARDS in adult patients

Tidal volumeStrongly in favourTidal volume <6 mL/kg ideal body weight; Plateau pressure < 30 cmH2O
Prone positioningStrongly in favourProning for >12 hours per day
Patients with moderate/severe ARDS (P:F ratio < 20 kPa)
HFOVStrongly against
Conservative fluid managementWeakly in favour
Higher PEEPWeakly in favourPatients with moderate or severe ARDS (PF ratio <27 kPa)
NMBAWeakly in favourEvidence only for cisatracurium besylate
Continuous 48 hours infusion
Patients with moderate/severe ARDS (<20 kPa)
ECMOWeakly in favourWith lung-protective mechanical ventilation
Patients with severe ARDS, lung injury score >3 or pH <7.20 due to uncompensated hypercapnoea
Inhaled vasodilatorsWeakly againstEvidence only for inhaled nitric oxide
CorticosteroidsResearch recommendation
ECCO2RResearch recommendation
  • ARDS, acute respiratory distress syndrome; ECCO2R, extracorporeal carbon dioxide removal; ECMO, extracorporeal membrane oxygenation; FICM, Faculty of Intensive Care Medicine; HFOV, high frequency oscillation; ICS, Intensive Care Society; NMBA, neuromuscular blocking agents; PEEP, peek end-expiratory pressure.