Acute respiratory distress syndrome guidelines: oceans apart or rivers that merge?

Excerpt

Recently, international experts in acute respiratory distress syndrome (ARDS) have released two sets of guidelines on the respiratory management of ARDS, on behalf of the European Society of Intensive Care Medicine (ESICM) [1] and the American Thoracic Society (ATS) [2]. These guidelines aimed to synthesize evidence from randomised trials, while also leveraging the clinical expertise of a panel of experts to enhance their practical applicability. Although the ESICM guidelines included more authors, with a wider geographical representation, and notably involved a panel of patients and their family members in the compilation and authorship process, there is a partial overlap in authorship between the two guidelines. Despite these and other similarities, the two guidelines differ in several aspects including the process to identify and select the panel of experts and the deliberative process, which led to different formulation of questions and in some recommendations. These discrepancies should be interpreted considering the methodology used and the premise that recommendations in the ESICM guidelines are intended for ‘routine care’, meaning that they should be applicable to all ARDS patients. …