PT - JOURNAL ARTICLE AU - J. Fernando Santacruz AU - Enrique Diaz Guzman Zavala AU - Alejandro C. Arroliga TI - Update in ARDS management: Recent randomized controlled trials that changed our practice DP - 2006 Mar 01 TA - Cleveland Clinic Journal of Medicine PG - 217--236 VI - 73 IP - 3 4099 - http://www.ccjm.org/content/73/3/217.short 4100 - http://www.ccjm.org/content/73/3/217.full SO - Cleve Clin J Med2006 Mar 01; 73 AB - In the last 7 years, 14 randomized controlled trials in patients with acute respiratory distress syndrome (ARDS) have shown that: Mechanical ventilation with a tidal volume of 6 mL/kg of predicted body weight is better than mechanical ventilation with a tidal volume of 12 mL/kg of predicted body weight.Prone positioning improves oxygenation but poses safety concerns.A high level of positive end-expiratory pressure does not improve survival.High-frequency oscillatory ventilation is in theory the ideal “lung-protective” method, but its benefits have not been proven.No drug therapy has been shown to improve survival in patients with ARDS.Exogenous surfactant may improve oxygenation but has no significant effect on the death rate or length of use of mechanical ventilation.Low-dose inhaled nitric oxide has no substantial impact on the duration of ventilatory support or on the death rate.Partial liquid ventilation may be beneficial in young patients with acute lung injury or ARDS, although further study is needed to confirm this.