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Hengitysvajaus (äkillinen)
Käypä hoito -suositus |  Julkaistu: 2014-05-23   | Tila: voimassa  |  Aihepiiri(t): Anestesiologia ja tehohoito, Keuhkosairaudet, Kuntoutus, Yleislääketiede
Mikä on Käypä hoito -suositus?
Suomalaisen Lääkäriseuran Duodecimin ja Suomen Anestesiologiyhdistyksen asettama työryhmä
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Hengitysvajaus (äkillinen)

Käypä hoito
23.5.2014
Suomalaisen Lääkäriseuran Duodecimin ja Suomen Anestesiologiyhdistyksen asettama työryhmä

Opi ja ota käyttöön

Koosteet

Muut suositukset

Miten viitata Käypä hoito -suositukseen? «»1

Mitä uutta päivityksessä?

  • Äkillisen hengitysvajausoireyhtymän (ARDS:n) määritelmä on päivitetty. Uuden määritelmän mukaan oireyhtymä jaetaan potilaan hoitoon ja happeutumiseen liittyvien tietojen perusteella lievään, kohtalaiseen ja vaikeaan muotoon. Termiä akuutti keuhkovaurio (ALI) ei tässä yhteydessä enää käytetä oireyhtymän lievästä muodosta.
  • Suomessa invasiivista tai noninvasiivista hengityslaitehoitoa tarvinneiden hengitysvajauspotilaiden kuolleisuus on noin 35–40 %.
  • Näyttö noninvasiivisen ventilaation (NIV) käytön ennusteellisesta hyödystä keuhkoahtaumataudin (COPD) vaikeutumisvaiheen hoidossa on vahva, mutta hypokseemisessa hengitysvajauksessa näyttö on edelleen puutteellista.
  • Keuhkojen ylivenytyksen välttämisellä parannetaan ARDS-potilaiden ennustetta ja estetään lisäkomplikaatioiden kehittymistä myös muilla hengityslaitehoitoa saavilla potilailla.
  • Kehonulkoisten happeuttamistekniikoiden käytöstä vaikean kaasujenvaihtohäiriön hoidossa ei ole vielä luotettavaa tutkimusnäyttöä.

Keskeinen sisältö

  • Hengitysvajaus on tavallisin vakaviin sairauksiin liittyvä henkeä uhkaava elintoimintojen häiriö.
  • Äkillisen hengitysvajauksen alkuvaiheen ensisijaisia hoitomuotoja ovat noninvasiiviset hengityslaitehoidot maskin avulla.
  • Hengitysteiden varmistaminen intubaatiolla ja mekaanisen ventilaation aloittaminen perustuvat hengityksen lisäksi myös muiden elintoimintojen, erityisesti verenkierron ja tajunnanhäiriöiden kokonaisvaltaiseen arviointiin.
  • Hengityslaitehoidossa tulee välttää liian suurta keuhkojen tai keuhkorakkuloiden venytyspainetta ja kertahengitystilavuutta.
  • Uloshengitysvaiheen paine (PEEP) tulee säätää happeutumisen ja verenkierron kokonaisarvion perusteella.
  • Hengityskoneesta ja invasiivisesta ilmatiestä vieroittumisen edellytysten päivittäinen, säännönmukainen arvioiminen lyhentää hengityslaitehoidon kestoa.
  • Varhain aloitettu aktiivinen kuntoutus nopeuttaa hengitysvajauspotilaiden toimintakyvyn palautumista.

Tavoite ja kohderyhmä

  • Suosituksen tavoitteena on yhdenmukaistaa ja tarkentaa äkillisen hengitysvajauksen hoitoa.
  • Suosituksessa ei käsitellä hengitysvajaukseen johtavien sairauksien diagnostiikkaa ja hoitoa.
  • Suositus on tarkoitettu erikoissairaanhoidossa, ensihoidossa ja perusterveydenhuollossa aikuisia hengitysvajauspotilaita hoitavalle henkilöstölle.
  • Suosituksessa käytettävät lyhenteet esitetään taulukossa «Hengitysvajaukseen liittyviä lyhenteitä.»1.
Taulukko 1. Hengitysvajaukseen liittyviä lyhenteitä.
ARDS = Acute Respiratory Distress Syndrome, vaikea äkillinen hengitysvajausoireyhtymä
AVAPS = Average Volume Assured Pressure Support
BIPAP = Bi-level Positive Airway Pressure, kaksivaiheinen positiivinen ilmatiepaine
CPAP = Continuous Positive Airway Pressure, jatkuva positiivinen ilmatiepaine
ECCO2-R = Extracorporeal CO2 Removal, kehonulkoinen, lähinnä hiilidioksidin poistoa tekevä hengitystoimintaa avustava tekniikka
ECMO = Extracorporeal Membrane Oxygenation, kehonulkoinen happeuttaminen
FiO2 = Fraction of Inspired Oxygen, sisäänhengitysilman happiosuus (happifraktio)
FRC = Functional Residual Capacity, keuhkojen jäännösilmatilavuus eli uloshengityksen lopussa keuhkoihin jäävä ilmamäärä
EPAP = Expiratory Positive Airway Pressure, uloshengityksen aikainen positiivinen paine, uloshengityspaine
IPAP = Inspiratory Positive Airway Pressure, sisäänhengityksen aikainen positiiviinen paine, sisäänhengityspaine
NIV = Noninvasiivinen ventilaatio
NHFO = Nasal High Flow Oxygen; suurivirtauksinen happihoito (nenäkanyylien kautta)
PaO2 = Valtimoveren happiosapaine
PaCO2 = Valtimoveren hiilidioksidiosapaine
PaO2/FiO2-suhde eli P/F-suhde: Valtimoveren happiosapaineen ja sen saavuttamiseksi käytetyn sisäänhengitysilman happifraktion suhde
PAV = Proportional Assist Ventilation
PEEP = Positive End-expiratory Pressure, positiivinen loppu-uloshengityspaine
PSV = Pressure Support Ventilation, painetukiventilaatio
Pplat = Plateau Pressure, hengitysteiden tasannepaine sisäänhengityksen lopussa
2 PV-hoito = Kaksoispaineventilaatio
SaO2 = Valtimoveren hemoglobiinin happikyllästeisyys
SpO2 = Pulssioksimetrilla mitattu SaO2
TV = Tidal Volume, kertahengitystilavuus
VALI = Ventilator Associated Lung Injury, hengityslaitehoitoon liittyvä keuhkovaurio
VAP = Ventilator Associated Pneumonia

Määritelmiä

Taulukko 2. ARDS:aan liittyvät tavallisimmat äkilliset taustasairaudet.
Suoran keuhkovaurion aiheuttavat sairaudet Epäsuoran keuhkovaurion aiheuttavat sairaudet
Keuhkokuume Sepsis
Aspiraatio Pankreatiitti
Savukaasujen hengittäminen Monivammautuminen
Keuhkokontuusio Massiivinen verensiirto
Hukkuminen Vaikeat palovammat

Äkillisen hengitysvajauksen patofysiologia

Taulukko 3. Esimerkkejä tavallisimmista äkilliseen hengitysvajaukseen johtavista sairauksista.
Ensisijaisesti ventilaatiovajaus Ensisijaisesti alveolitason kaasujenvaihtohäiriö
Keskushermostoa lamaavat lääkkeet, sairaudet ja vammat Keuhkopöhö
Hermo-lihassairaudet Akuutti keuhkovaurio ja äkillinen hengitysvajausoireyhtymä
Keuhkoahtaumatauti Keuhkokuume
Rintakehän epämuodostumat ja muut rintakehän liikkumista rajoittavat sairaudet Keuhkoveritulppa
Vaikea lihavuus Diffuusit keuhkokudoksen sairaudet

Hengitysvajauksen epidemiologia ja ennuste

Diagnostiikka

Oireet ja löydökset

Tutkimukset

Hoito

Avoimen hengitystien varmistaminen

Sisäänhengitysilman happiosuuden (FiO2) suurentaminen spontaanisti hengittävällä potilaalla

Aiheet:

Toteutus:

CPAP-maskihoito (Continuous Positive Airway Pressure)

Noninvasiivinen ventilaatio (NIV)

Taulukko 4. NIV:n vasta-aiheet «British Thoracic Society Standards of Care Committee. Non-invasive ventilation in acute respiratory failure. Thorax 2002;57:192-211 »4, «Bello G, De Pascale G, Antonelli M. Noninvasive ventilation: practical advice. Curr Opin Crit Care 2013;19:1-8 »31, «Hess DR. Noninvasive ventilation for acute respiratory failure. Respir Care 2013;58:950-72 »34.
Ehdottomat
Potilaalla on hengityksen pysähdys.
Maskin käyttö ei onnistu.
Suhteelliset
Epävakaa verenkiertotilanne
Sokki, vaikea akuutti sydäntapahtuma
Tajunnan merkittävä heikkeneminen (joka ei liity pelkästään hiilidioksidin kertymiseen)
Potilaan kykenemättömyys yhteistyöhön
Hallitsematon sekavuus tai kiihtyneisyys
Keinoilmatien tarve avoimen ilmatien varmistamiseksi
Ylähengitysteiden pysyvä ahtauma
Suuri aspiraatioriski
Ylähengitysteiden verenvuoto
Runsas limaneritys
Äskettäinen kasvojen, ylähengitysteiden tai mahasuolikanavan yläosan vamma tai leikkaus
Hoitamaton ilmarinta

NIV:n toteuttaminen:

NIV:n aloitussäädöt

  • Uloshengityspaine (EPAP, vastaa PEEP:tä) asetetaan arvoon 4–5 cmH2O ja sitä suurennetaan happeutumistavoitteen perusteella «Bello G, De Pascale G, Antonelli M. Noninvasive ventilation: practical advice. Curr Opin Crit Care 2013;19:1-8 »31.
    • Uloshengityspaineen suurentaminen parantaa happeutumista ja estää ylähengitysteiden ahtautumista.
    • Suurempi EPAP on hyödyksi, jos potilaalla on ahtaat ylähengitystiet (uniapneataipumus, liikapaino) tai kaasujenvaihtohäiriö.
  • Happiosuus (FiO2) säädetään laitteesta tai lisähappivirtaus lisätään mukaan siten, että saavutetaan tavoitteen mukainen SpO2.
  • Sisäänhengityspaine (IPAP) asetetaan arvoon 10–12 cmH2O ja sitä suurennetaan vähitellen riittävän ventilaation ja kertahengitystilavuuden 5–8 ml/kg saavuttamiseksi, kunnes hoitovaste tai korkein siedetty painetaso on saavutettu.

Invasiivinen hengityslaitehoito

Taulukko 5. Tavanomainen PEEP-taso. Positiivisen uloshengityksen paineen säätämisestä on esitetty useita periaatteita. Minkään säätötavan käytön ei ole voitu osoittaa parantavan ennustetta. Yksinkertaiset säätötavat perustuvat happeutumistavoitteeseen pääsemiseksi tarvittavan happifraktion osuuteen. Tavanomaisia PEEP-tasoja käytettäessä PEEP voidaan säätää oheisen taulukon mukaisesti:
FiO2 0,4 0,5 0,6 0,7 0,8 0,9 1,0
PEEP 5 8 10 12 14 16 16–18
Taulukko 6. Korkea PEEP-taso. Ne ARDS-potilaat, joiden happeutuminen kohenee ja joiden uloshengityksen lopun keuhkotilavuus kasvaa niin sanotuilla rekrytointitoimilla, hyötynevät korkeammasta PEEP:stä. Heillä PEEP-tasoa voidaan säätää käyttämällä oheista taulukkoa.
FiO2 0,4 0,5 0,6 0,7 0,8 0,9 1,0
PEEP 10 12 14 16 18 20 20–24

Keinoilmatien hoitaminen hengityslaitehoidon yhteydessä

Hengitysvajaukseen liittyvät ei-ventilatoriset hoidot

Vieroitus hengityslaitehoidosta

Potilaan seuranta hengityslaitehoidon aikana

Kuntoutus

Hoidon toteutus ja porrastus

Arviointikriteerit

  • Äkillistä hengitysvajausta sairastavia hoitavien erikoissairaanhoidon yksiköiden tulee seurata
    • hengityslaitehoitoa tarvitsevien potilaiden määrää
    • hoidon toteutumista:
      • NIV:llä hoidettavien osuutta
      • invasiivisesti hoidettavien osuutta
      • hengityslaitehoidon kestoa
      • hoidonaikaista kertahengitystilavuutta ja sisäänhengityspainetta
      • sairaalainfektioiden ja erityisesti keuhkokuumeen esiintyvyyttä
      • hengityslaitehoitoon liittyviä komplikaatioita
    • hengitysvajauspotilaiden hoidon lopputulosta:
      • kuolleisuutta
      • sairaalahoidon kestoa
      • elämänlaatua.

Suomalaisen Lääkäriseuran Duodecimin ja Suomen Anestesiologiyhdistyksen asettama työryhmä

Hengitysvajaus (äkillinen) historiatiedot «Hengitysvajaus (äkillinen), Käypä hoito -suosituksen historiatiedot»4

Puheenjohtaja:

Tero Varpula, LT, dosentti, osastonylilääkäri; HYKS, tehoklinikka

Jäsenet:

Pirkko Brander, dosentti, ylilääkäri; HYKS, Sydän- ja keuhkokeskus, keuhkosairauksien klinikka

Tom Bäcklund, LL, sisätautien erikoislääkäri; HUS, Meilahden sairaalan tehovalvontaosasto

Anna Eklund, LL, anestesiologian erikoislääkäri; Lapin keskussairaala

Juha Koskenkari, LT, apulaisylilääkäri; OYS, Operatiivinen tulosalue, teho-osasto

Anne Kuitunen, dosentti, apulaisylilääkäri; TAYS, tehohoito

Tuula Meinander, LL, sisätauteihin erikoistuva lääkäri; TAYS, Käypä hoito -toimittaja

Ilkka Parviainen, LT, dosentti, osastonylilääkäri; KYS, päivystys- ja tehohoito

Asiantuntijat:

Heikki Ekroos

Marjatta Okkonen

Sidonnaisuudet:

Pirkko Brander: Asiantuntijapalkkioita (Helsingin yliopisto, Turun yliopisto), johtokunnan jäsen (Hengityssairauksien tutkimussäätiö), työsuhde (HUS), luentopalkkioita (Astra Zeneca, Glaxo Smith Kline, Turunmaan Duodecim-seura, Päijät-Hämeen sairaanhoitopiiri), tekijänpalkkio (Kustannus Oy Duodecim), osakeomistuksia (Nordea, UPM-Kymmene), koulutus- ja kongressimatkoja yrityksen tuella (Lääketehdas Pierre Fabre Pharma Norden)

Tom Bäcklund: Luentopalkkio (Orion Oyj 2012)

Anna Eklund: Ei sidonnaisuuksia

Juha Koskenkari: Luentopalkkio (Pfizer Oy), koulutus- ja kongressimatkoja yritysten tuella (CSL Behring Ab, Orion Oyj)

Anne Kuitunen: Luentopalkkio (Suomen tehohoitoyhdistys)

Tuula Meinander: Apurahoja (Suomen Angiologiayhdistys 2014, Suomen Kulttuurirahasto, Pirkanmaan Maakuntarahasto 2008, Suomen kardiologinen seura 2011, Valtakunnallinen kliininen tutkijakoulu 2010–2014), asiantuntijapalkkioita (Suomalainen Lääkäriseura Duodecim), työsuhde (Keski-Suomen keskussairaala 2011–2012, Suomen Kardiologinen Seura 2012–2014, Tampereen yliopistollinen sairaala 2006–2014), luentopalkkio (TAYS, Lastenklinikka), Suomen Lääkäriliiton Edunvalvontavaliokunnan Tampereen paikallisosaston jäsen

Ilkka Parviainen: Luentopalkkio (B.Braun Medical Oy)

Tero Varpula: Luentopalkkioita (Aesculapius Academy, Pfizer Oy)

Kirjallisuusviite

Hengitysvajaus (äkillinen) (online). Suomalaisen Lääkäriseuran Duodecimin ja Suomen Anestesiologiyhdistyksen asettama työryhmä. Helsinki: Suomalainen Lääkäriseura Duodecim, 2014 (viitattu pp.kk.vvvv). Saatavilla internetissä: www.kaypahoito.fi

Tarkemmat viittausohjeet: «http://www.kaypahoito.fi/web/kh/viittaaminen»1

Vastuun rajaus

Käypä hoito -suositukset ovat parhaiden asiantuntijoiden laatimia yhteenvetoja yksittäisten sairauksien diagnostiikan ja hoidon vaikuttavuudesta. Ne eivät korvaa lääkärin tai muun terveydenhuollon ammattilaisen omaa arviota yksittäisen potilaan parhaasta mahdollisesta diagnostiikasta ja hoidosta hoitopäätöksiä tehtäessä.

Tiedonhakukäytäntö

Systemaattinen kirjallisuushaku on hoitosuosituksen perusta. Lue lisää artikkelista khk00007

Kirjallisuutta

  1. Shelly MP, Nightingale P. ABC of intensive care: respiratory support. BMJ 1999;318:1674-7 «PMID: 10373174»PubMed
  2. Roussos C, Koutsoukou A. Respiratory failure. Eur Respir J Suppl 2003;47:3s-14s «PMID: 14621112»PubMed
  3. Linko R. Incidence, treatment and outcome of critically ill patients with acute respiratory failure. Academic dissortation, University of Helsinki 2012;1-104
  4. British Thoracic Society Standards of Care Committee. Non-invasive ventilation in acute respiratory failure. Thorax 2002;57:192-211 «PMID: 11867822»PubMed
  5. O'Driscoll BR, Howard LS, Bucknall C ym. British Thoracic Society emergency oxygen audits. Thorax 2011;66:734-5 «PMID: 21502096»PubMed
  6. Nee PA, Al-Jubouri MA, Gray AJ ym. Critical care in the emergency department: acute respiratory failure. Emerg Med J 2011;28:94-7 «PMID: 21112972»PubMed
  7. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD ym. Acute respiratory distress syndrome: the Berlin Definition. JAMA 2012;307:2526-33 «PMID: 22797452»PubMed
  8. Bernard GR, Artigas A, Brigham KL ym. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994;149:818-24 «PMID: 7509706»PubMed
  9. Akuuttihoidon tietokannat - Duodecim [Internet]. terveysportti.fi. 2013 [cited 2013 Sep 12]. Available from: http://www.terveysportti.fi/dtk/aho/koti
  10. Pinsky MR. Cardiovascular issues in respiratory care. Chest 2005;128:592S-597S «PMID: 16306058»PubMed
  11. O'Driscoll BR, Howard LS, Davison AG ym. BTS guideline for emergency oxygen use in adult patients. Thorax 2008;63 Suppl 6:vi1-68 «PMID: 18838559»PubMed
  12. Vincent JL, Akça S, De Mendonça A ym. The epidemiology of acute respiratory failure in critically ill patients(*). Chest 2002;121:1602-9 «PMID: 12006450»PubMed
  13. Luhr OR, Antonsen K, Karlsson M ym. Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. The ARF Study Group. Am J Respir Crit Care Med 1999;159:1849-61 «PMID: 10351930»PubMed
  14. Rubenfeld GD, Caldwell E, Peabody E ym. Incidence and outcomes of acute lung injury. N Engl J Med 2005;353:1685-93 «PMID: 16236739»PubMed
  15. Bersten AD, Edibam C, Hunt T ym. Incidence and mortality of acute lung injury and the acute respiratory distress syndrome in three Australian States. Am J Respir Crit Care Med 2002;165:443-8 «PMID: 11850334»PubMed
  16. Villar J, Pérez-Méndez L, Kacmarek RM. Current definitions of acute lung injury and the acute respiratory distress syndrome do not reflect their true severity and outcome. Intensive Care Med 1999;25:930-5 «PMID: 10501747»PubMed
  17. Nuckton TJ, Alonso JA, Kallet RH ym. Pulmonary dead-space fraction as a risk factor for death in the acute respiratory distress syndrome. N Engl J Med 2002;346:1281-6 «PMID: 11973365»PubMed
  18. Brochard L, Martin GS, Blanch L ym. Clinical review: Respiratory monitoring in the ICU - a consensus of 16. Crit Care 2012;16:219 «PMID: 22546221»PubMed
  19. Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet 2009;374:250-9 «PMID: 19616722»PubMed
  20. Nava S, Grassi M, Fanfulla F ym. Non-invasive ventilation in elderly patients with acute hypercapnic respiratory failure: a randomised controlled trial. Age Ageing 2011;40:444-50 «PMID: 21345841»PubMed
  21. Keenan SP, Mehta S. Noninvasive ventilation for patients presenting with acute respiratory failure: the randomized controlled trials. Respir Care 2009;54:116-26 «PMID: 19111111»PubMed
  22. Nava S, Schreiber A, Domenighetti G. Noninvasive ventilation for patients with acute lung injury or acute respiratory distress syndrome. Respir Care 2011;56:1583-8 «PMID: 22008399»PubMed
  23. Hill NS, Brennan J, Garpestad E ym. Noninvasive ventilation in acute respiratory failure. Crit Care Med 2007;35:2402-7 «PMID: 17717495»PubMed
  24. Roberts CM, Brown JL, Reinhardt AK ym. Non-invasive ventilation in chronic obstructive pulmonary disease: management of acute type 2 respiratory failure. Clin Med 2008;8:517-21 «PMID: 18975486»PubMed
  25. Keenan SP, Sinuff T, Burns KE ym. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ 2011;183:E195-214 «PMID: 21324867»PubMed
  26. Branson RD, Johannigman JA. Pre-hospital oxygen therapy. Respir Care 2013;58:86-97 «PMID: 23271821»PubMed
  27. Cornet AD, Kooter AJ, Peters MJ ym. The potential harm of oxygen therapy in medical emergencies. Crit Care 2013;17:313 «PMID: 23635028»PubMed
  28. Kernick J, Magarey J. What is the evidence for the use of high flow nasal cannula oxygen in adult patients admitted to critical care units? A systematic review. Aust Crit Care 2010;23:53-70 «PMID: 20206546»PubMed
  29. Ricard JD. High flow nasal oxygen in acute respiratory failure. Minerva Anestesiol 2012;78:836-41 «PMID: 22531566»PubMed
  30. Sztrymf B, Messika J, Mayot T ym. Impact of high-flow nasal cannula oxygen therapy on intensive care unit patients with acute respiratory failure: a prospective observational study. J Crit Care 2012;27:324.e9-13 «PMID: 21958974»PubMed
  31. Bello G, De Pascale G, Antonelli M. Noninvasive ventilation: practical advice. Curr Opin Crit Care 2013;19:1-8 «PMID: 23235541»PubMed
  32. Brander PE. [Noninvasive ventilation and acute respiratory failure]. Duodecim 2011;127:167-75 «PMID: 21442866»PubMed
  33. Squadrone V, Coha M, Cerutti E ym. Continuous positive airway pressure for treatment of postoperative hypoxemia: a randomized controlled trial. JAMA 2005;293:589-95 «PMID: 15687314»PubMed
  34. Hess DR. Noninvasive ventilation for acute respiratory failure. Respir Care 2013;58:950-72 «PMID: 23709194»PubMed
  35. Schortgen F, Follin A, Piccari L ym. Results of noninvasive ventilation in very old patients. Ann Intensive Care 2012;2:5 «PMID: 22353636»PubMed
  36. Ram FS, Picot J, Lightowler J ym. Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2004;(3):CD004104 «PMID: 15266518»PubMed
  37. Linko R, Okkonen M, Pettilä V ym. Acute respiratory failure in intensive care units. FINNALI: a prospective cohort study. Intensive Care Med 2009;35:1352-61 «PMID: 19526218»PubMed
  38. Gupta D, Nath A, Agarwal R ym. A prospective randomized controlled trial on the efficacy of noninvasive ventilation in severe acute asthma. Respir Care 2010;55:536-43 «PMID: 20420722»PubMed
  39. Curtis JR, Cook DJ, Sinuff T ym. Noninvasive positive pressure ventilation in critical and palliative care settings: understanding the goals of therapy. Crit Care Med 2007;35:932-9 «PMID: 17255876»PubMed
  40. Sinuff T, Cook DJ, Keenan SP ym. Noninvasive ventilation for acute respiratory failure near the end of life. Crit Care Med 2008;36:789-94 «PMID: 18209669»PubMed
  41. Kuolevan potilaan oireiden hoito (online). Käypä hoito -suositus. Suomalaisen Lääkäriseuran Duodecimin ja Suomen Palliatiivisen Lääketieteen yhdistyksen asettama työryhmä. Helsinki: Suomalainen Lääkäriseura Duodecim, 2012
  42. Nava S, Ferrer M, Esquinas A ym. Palliative use of non-invasive ventilation in end-of-life patients with solid tumours: a randomised feasibility trial. Lancet Oncol 2013;14:219-27 «PMID: 23406914»PubMed
  43. Organized jointly by the American Thoracic Society, the European Respiratory Society, the European Society of Intensive Care Medicine, and the Société de Réanimation de Langue Française, and approved by ATS Board of Directors, December 2000. International Consensus Conferences in Intensive Care Medicine: noninvasive positive pressure ventilation in acute Respiratory failure. Am J Respir Crit Care Med 2001;163:283-91 «PMID: 11208659»PubMed
  44. Confalonieri M, Potena A, Carbone G ym. Acute respiratory failure in patients with severe community-acquired pneumonia. A prospective randomized evaluation of noninvasive ventilation. Am J Respir Crit Care Med 1999;160:1585-91 «PMID: 10556125»PubMed
  45. Girou E, Brun-Buisson C, Taillé S ym. Secular trends in nosocomial infections and mortality associated with noninvasive ventilation in patients with exacerbation of COPD and pulmonary edema. JAMA 2003;290:2985-91 «PMID: 14665660»PubMed
  46. Girou E, Schortgen F, Delclaux C ym. Association of noninvasive ventilation with nosocomial infections and survival in critically ill patients. JAMA 2000;284:2361-7 «PMID: 11066187»PubMed
  47. Ambrosino N, Vagheggini G. Noninvasive positive pressure ventilation in the acute care setting: where are we? Eur Respir J 2008;31:874-86 «PMID: 18378782»PubMed
  48. Ambrosino N. Should we perform noninvasive ventilation anywhere? Expert Rev Respir Med 2012;6:131-3 «PMID: 22455483»PubMed
  49. Ferreira JC, Chipman DW, Hill NS ym. Bilevel vs ICU ventilators providing noninvasive ventilation: effect of system leaks: a COPD lung model comparison. Chest 2009;136:448-56 «PMID: 19429723»PubMed
  50. Vagheggini G, Mazzoleni S, Vlad Panait E ym. Physiologic response to various levels of pressure support and NAVA in prolonged weaning. Respir Med 2013;107:1748-54 «PMID: 24035203»PubMed
  51. Murphy PB, Davidson C, Hind MD ym. Volume targeted versus pressure support non-invasive ventilation in patients with super obesity and chronic respiratory failure: a randomised controlled trial. Thorax 2012;67:727-34 «PMID: 22382596»PubMed
  52. Gajic O, Dara SI, Mendez JL ym. Ventilator-associated lung injury in patients without acute lung injury at the onset of mechanical ventilation. Crit Care Med 2004;32:1817-24 «PMID: 15343007»PubMed
  53. Pelosi P, Rocco PR. Ventilator-induced lung injury in healthy and diseased lungs: better to prevent than cure! Anesthesiology 2011;115:923-5 «PMID: 21946091»PubMed
  54. Biehl M, Kashiouris MG, Gajic O. Ventilator-induced lung injury: minimizing its impact in patients with or at risk for ARDS. Respir Care 2013;58:927-37 «PMID: 23709192»PubMed
  55. Futier E, Constantin JM, Paugam-Burtz C ym. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med 2013;369:428-37 «PMID: 23902482»PubMed
  56. Kavanagh BP, Laffey JG. Hypercapnia: permissive and therapeutic. Minerva Anestesiol 2006;72:567-76 «PMID: 16682931»PubMed
  57. Kregenow DA, Rubenfeld GD, Hudson LD ym. Hypercapnic acidosis and mortality in acute lung injury. Crit Care Med 2006;34:1-7 «PMID: 16374149»PubMed
  58. Bigatello LM, Patroniti N, Sangalli F. Permissive hypercapnia. Curr Opin Crit Care 2001;7:34-40 «PMID: 11373509»PubMed
  59. Eichacker PQ, Gerstenberger EP, Banks SM ym. Meta-analysis of acute lung injury and acute respiratory distress syndrome trials testing low tidal volumes. Am J Respir Crit Care Med 2002;166:1510-4 «PMID: 12406836»PubMed
  60. Deans KJ, Minneci PC, Danner RL ym. Practice misalignments in randomized controlled trials: Identification, impact, and potential solutions. Anesth Analg 2010;111:444-50 «PMID: 19820238»PubMed
  61. Gattinoni L, Caironi P, Cressoni M ym. Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med 2006;354:1775-86 «PMID: 16641394»PubMed
  62. Briel M, Meade M, Mercat A ym. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 2010;303:865-73 «PMID: 20197533»PubMed
  63. Talmor D, Sarge T, Malhotra A ym. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med 2008;359:2095-104 «PMID: 19001507»PubMed
  64. Amato MB, Barbas CS, Medeiros DM ym. Beneficial effects of the "open lung approach" with low distending pressures in acute respiratory distress syndrome. A prospective randomized study on mechanical ventilation. Am J Respir Crit Care Med 1995;152:1835-46 «PMID: 8520744»PubMed
  65. Lu Q, Vieira SR, Richecoeur J ym. A simple automated method for measuring pressure-volume curves during mechanical ventilation. Am J Respir Crit Care Med 1999;159:275-82 «PMID: 9872850»PubMed
  66. Hodgson C, Keating JL, Holland AE ym. Recruitment manoeuvres for adults with acute lung injury receiving mechanical ventilation. Cochrane Database Syst Rev 2009;(2):CD006667 «PMID: 19370647»PubMed
  67. Grasso S, Mascia L, Del Turco M ym. Effects of recruiting maneuvers in patients with acute respiratory distress syndrome ventilated with protective ventilatory strategy. Anesthesiology 2002;96:795-802 «PMID: 11964585»PubMed
  68. Constantin JM, Grasso S, Chanques G ym. Lung morphology predicts response to recruitment maneuver in patients with acute respiratory distress syndrome. Crit Care Med 2010;38:1108-17 «PMID: 20154600»PubMed
  69. Desai SR, Wells AU, Suntharalingam G ym. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary injury: a comparative CT study. Radiology 2001;218:689-93 «PMID: 11230641»PubMed
  70. McMullen SM, Meade M, Rose L ym. Partial ventilatory support modalities in acute lung injury and acute respiratory distress syndrome-a systematic review. PLoS One 2012;7:e40190 «PMID: 22916094»PubMed
  71. Daoud EG, Farag HL, Chatburn RL. Airway pressure release ventilation: what do we know? Respir Care 2012;57:282-92 «PMID: 21762559»PubMed
  72. Young D, Lamb SE, Shah S ym. High-frequency oscillation for acute respiratory distress syndrome. N Engl J Med 2013;368:806-13 «PMID: 23339638»PubMed
  73. Ferguson ND, Cook DJ, Guyatt GH ym. High-frequency oscillation in early acute respiratory distress syndrome. N Engl J Med 2013;368:795-805 «PMID: 23339639»PubMed
  74. Sud S, Sud M, Friedrich JO ym. High-frequency ventilation versus conventional ventilation for treatment of acute lung injury and acute respiratory distress syndrome. Cochrane Database Syst Rev 2013;2:CD004085 «PMID: 23450549»PubMed
  75. Branson RD. Secretion management in the mechanically ventilated patient. Respir Care 2007;52:1328-42; discussion 1342-7 «PMID: 17894902»PubMed
  76. Caruso P, Denari S, Ruiz SA ym. Saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia. Crit Care Med 2009;37:32-8 «PMID: 19050607»PubMed
  77. Muscedere J, Rewa O, McKechnie K ym. Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis. Crit Care Med 2011;39:1985-91 «PMID: 21478738»PubMed
  78. Leasure AR, Stirlen J, Lu SH. Prevention of ventilator-associated pneumonia through aspiration of subglottic secretions: a systematic review and meta-analysis. Dimens Crit Care Nurs 2012;31:102-17 «PMID: 22333720»PubMed
  79. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wiedemann HP, Wheeler AP ym. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006;354:2564-75 «PMID: 16714767»PubMed
  80. Papazian L, Forel JM, Gacouin A ym. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 2010;363:1107-16 «PMID: 20843245»PubMed
  81. Tang BM, Craig JC, Eslick GD ym. Use of corticosteroids in acute lung injury and acute respiratory distress syndrome: a systematic review and meta-analysis. Crit Care Med 2009;37:1594-603 «PMID: 19325471»PubMed
  82. Afshari A, Brok J, Møller A ym. Inhaled nitric oxide for acute respiratory distress syndrome and acute lung injury in adults and children: a systematic review with meta-analysis and trial sequential analysis. Anesth Analg 2011;112:1411-21 «PMID: 21372277»PubMed
  83. Pham T, Combes A, Rozé H ym. Extracorporeal membrane oxygenation for pandemic influenza A(H1N1)-induced acute respiratory distress syndrome: a cohort study and propensity-matched analysis. Am J Respir Crit Care Med 2013;187:276-85 «PMID: 23155145»PubMed
  84. Peek GJ, Mugford M, Tiruvoipati R ym. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009;374:1351-63 «PMID: 19762075»PubMed
  85. Bein T, Weber-Carstens S, Goldmann A ym. Lower tidal volume strategy (˜3 ml/kg) combined with extracorporeal CO2 removal versus 'conventional' protective ventilation (6 ml/kg) in severe ARDS: the prospective randomized Xtravent-study. Intensive Care Med 2013;39:847-56 «PMID: 23306584»PubMed
  86. Thille AW, Richard JC, Brochard L. The decision to extubate in the intensive care unit. Am J Respir Crit Care Med 2013;187:1294-302 «PMID: 23641924»PubMed
  87. Branson RD. Modes to facilitate ventilator weaning. Respir Care 2012;57:1635-48 «PMID: 23013901»PubMed
  88. Thille AW, Cortés-Puch I, Esteban A. Weaning from the ventilator and extubation in ICU. Curr Opin Crit Care 2013;19:57-64 «PMID: 23235542»PubMed
  89. Burns KE, Adhikari NK, Keenan SP ym. Noninvasive positive pressure ventilation as a weaning strategy for intubated adults with respiratory failure. Cochrane Database Syst Rev 2010;(8):CD004127 «PMID: 20687075»PubMed
  90. Blackwood B, Alderdice F, Burns KE ym. Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Syst Rev 2010;(5):CD006904 «PMID: 20464747»PubMed
  91. Folke M, Cernerud L, Ekström M ym. Critical review of non-invasive respiratory monitoring in medical care. Med Biol Eng Comput 2003;41:377-83 «PMID: 12892358»PubMed
  92. Mark S, Hyzy R. Mechanical ventilation in ARDS. 2012. pp. 1-16. UpToDate [online]. Wolters Kluwer Health. Saatavilla Internetissä «http://www.uptodate.com/contents/search?search=Mechanical+ventilation+in+acute+respiratory+distress+syndrome&x=9&y=8»2
  93. Vincent JL, Rhodes A, Perel A ym. Clinical review: Update on hemodynamic monitoring--a consensus of 16. Crit Care 2011;15:229 «PMID: 21884645»PubMed
  94. McArthur CD, AARC. AARC clinical practice guideline. Capnography/capnometry during mechanical ventilation--2003 revision & update. Respir Care 2003;48:534-9 «PMID: 12778894»PubMed
  95. Dellinger RP, Levy MM, Rhodes A ym. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013;39:165-228 «PMID: 23361625»PubMed
  96. Herridge MS, Cheung AM, Tansey CM ym. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 2003;348:683-93 «PMID: 12594312»PubMed
  97. Herridge MS, Tansey CM, Matté A ym. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011;364:1293-304 «PMID: 21470008»PubMed
  98. Masclans JR, Roca O, Muñoz X ym. Quality of life, pulmonary function, and tomographic scan abnormalities after ARDS. Chest 2011;139:1340-6 «PMID: 21330382»PubMed
  99. Hermans G, De Jonghe B, Bruyninckx F ym. Clinical review: Critical illness polyneuropathy and myopathy. Crit Care 2008;12:238 «PMID: 19040777»PubMed
  100. Bercker S, Weber-Carstens S, Deja M ym. Critical illness polyneuropathy and myopathy in patients with acute respiratory distress syndrome. Crit Care Med 2005;33:711-5 «PMID: 15818093»PubMed
  101. Schweickert WD, Pohlman MC, Pohlman AS ym. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 2009;373:1874-82 «PMID: 19446324»PubMed
  102. Ambrosino N, Makhabah DN. Comprehensive physiotherapy management in ARDS. Minerva Anestesiol 2013;79:554-63 «PMID: 23306398»PubMed
  103. Oeyen SG, Vandijck DM, Benoit DD ym. Quality of life after intensive care: a systematic review of the literature. Crit Care Med 2010;38:2386-400 «PMID: 20838335»PubMed
  104. Hopkins RO, Weaver LK, Collingridge D ym. Two-year cognitive, emotional, and quality-of-life outcomes in acute respiratory distress syndrome. Am J Respir Crit Care Med 2005;171:340-7 «PMID: 15542793»PubMed
  105. Bienvenu OJ, Colantuoni E, Mendez-Tellez PA ym. Depressive symptoms and impaired physical function after acute lung injury: a 2-year longitudinal study. Am J Respir Crit Care Med 2012;185:517-24 «PMID: 22161158»PubMed
  106. Linko R, Suojaranta-Ylinen R, Karlsson S ym. One-year mortality, quality of life and predicted life-time cost-utility in critically ill patients with acute respiratory failure. Crit Care 2010;14:R60 «PMID: 20384998»PubMed
  107. Agarwal R, Srinivas R, Nath A ym. Is the mortality higher in the pulmonary vs the extrapulmonary ARDS? A meta analysis. Chest 2008;133:1463-73 «PMID: 17989150»PubMed
  108. Erickson SE, Martin GS, Davis JL ym. Recent trends in acute lung injury mortality: 1996-2005. Crit Care Med 2009;37:1574-9 «PMID: 19325464»PubMed
  109. Phua J, Badia JR, Adhikari NK ym. Has mortality from acute respiratory distress syndrome decreased over time?: A systematic review. Am J Respir Crit Care Med 2009;179:220-7 «PMID: 19011152»PubMed
  110. Salim A, Martin M, Constantinou C ym. Acute respiratory distress syndrome in the trauma intensive care unit: Morbid but not mortal. Arch Surg 2006;141:655-8 «PMID: 16847235»PubMed
  111. Vincent JL, Sakr Y, Groeneveld J ym. ARDS of early or late onset: does it make a difference? Chest 2010;137:81-7 «PMID: 19820081»PubMed
  112. Zambon M, Vincent JL. Mortality rates for patients with acute lung injury/ARDS have decreased over time. Chest 2008;133:1120-7 «PMID: 18263687»PubMed
  113. Cooke CR, Kahn JM, Caldwell E ym. Predictors of hospital mortality in a population-based cohort of patients with acute lung injury. Crit Care Med 2008;36:1412-20 «PMID: 18434894»PubMed
  114. Damluji A, Colantuoni E, Mendez-Tellez PA ym. Short-term mortality prediction for acute lung injury patients: external validation of the Acute Respiratory Distress Syndrome Network prediction model. Crit Care Med 2011;39:1023-8 «PMID: 21761595»PubMed
  115. Austin MA, Wills KE, Blizzard L ym. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. BMJ 2010;341:c5462 «PMID: 20959284»PubMed
  116. BTS guidelines for the management of chronic obstructive pulmonary disease. The COPD Guidelines Group of the Standards of Care Committee of the BTS. Thorax 1997;52 Suppl 5:S1-28 «PMID: 9474238»PubMed
  117. Gomersall CD, Joynt GM, Freebairn RC ym. Oxygen therapy for hypercapnic patients with chronic obstructive pulmonary disease and acute respiratory failure: a randomized, controlled pilot study. Crit Care Med 2002;30:113-6 «PMID: 11905405»PubMed
  118. Plant PK, Elliott MW. Chronic obstructive pulmonary disease * 9: management of ventilatory failure in COPD. Thorax 2003;58:537-42 «PMID: 12775872»PubMed
  119. Wijesinghe M, Perrin K, Healy B ym. Pre-hospital oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. Intern Med J 2011;41:618-22 «PMID: 20214690»PubMed
  120. Agustí AG, Carrera M, Barbé F ym. Oxygen therapy during exacerbations of chronic obstructive pulmonary disease. Eur Respir J 1999;14:934-9 «PMID: 10573245»PubMed
  121. Bersten AD, Holt AW, Vedig AE ym. Treatment of severe cardiogenic pulmonary edema with continuous positive airway pressure delivered by face mask. N Engl J Med 1991;325:1825-30 «PMID: 1961221»PubMed
  122. Gray A, Goodacre S, Newby DE ym. Noninvasive ventilation in acute cardiogenic pulmonary edema. N Engl J Med 2008;359:142-51 «PMID: 18614781»PubMed
  123. Kelly CA, Newby DE, McDonagh TA ym. Randomised controlled trial of continuous positive airway pressure and standard oxygen therapy in acute pulmonary oedema; effects on plasma brain natriuretic peptide concentrations. Eur Heart J 2002;23:1379-86 «PMID: 12191749»PubMed
  124. L'Her E, Duquesne F, Girou E ym. Noninvasive continuous positive airway pressure in elderly cardiogenic pulmonary edema patients. Intensive Care Med 2004;30:882-8 «PMID: 14991092»PubMed
  125. Lin M, Yang YF, Chiang HT ym. Reappraisal of continuous positive airway pressure therapy in acute cardiogenic pulmonary edema. Short-term results and long-term follow-up. Chest 1995;107:1379-86 «PMID: 7750335»PubMed
  126. Mariani J, Macchia A, Belziti C ym. Noninvasive ventilation in acute cardiogenic pulmonary edema: a meta-analysis of randomized controlled trials. J Card Fail 2011;17:850-9 «PMID: 21962424»PubMed
  127. Räsänen J, Heikkilä J, Downs J ym. Continuous positive airway pressure by face mask in acute cardiogenic pulmonary edema. Am J Cardiol 1985;55:296-300 «PMID: 3881920»PubMed
  128. Ducros L, Logeart D, Vicaut E ym. CPAP for acute cardiogenic pulmonary oedema from out-of-hospital to cardiac intensive care unit: a randomised multicentre study. Intensive Care Med 2011;37:1501-9 «PMID: 21805159»PubMed
  129. Frontin P, Bounes V, Houzé-Cerfon CH ym. Continuous positive airway pressure for cardiogenic pulmonary edema: a randomized study. Am J Emerg Med 2011;29:775-81 «PMID: 20825901»PubMed
  130. Kallio T, Kuisma M, Alaspää A ym. The use of prehospital continuous positive airway pressure treatment in presumed acute severe pulmonary edema. Prehosp Emerg Care 2003;7:209-13 «PMID: 12710780»PubMed
  131. Global Strategy for the Diagnosis, Management and Prevention of chronic obstructive pulmonary disease. Päivitetty 2013. Luku 5: Management of exacerbations; sivu 56. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013.
  132. Plant PK, Owen JL, Elliott MW. Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet 2000;355:1931-5 «PMID: 10859037»PubMed
  133. Plant PK, Owen JL, Elliott MW. Non-invasive ventilation in acute exacerbations of chronic obstructive pulmonary disease: long term survival and predictors of in-hospital outcome. Thorax 2001;56:708-12 «PMID: 11514692»PubMed
  134. Azoulay E, Demoule A, Jaber S ym. Palliative noninvasive ventilation in patients with acute respiratory failure. Intensive Care Med 2011;37:1250-7 «PMID: 21656292»PubMed
  135. Azoulay E, Kouatchet A, Jaber S ym. Noninvasive mechanical ventilation in patients having declined tracheal intubation. Intensive Care Med 2013;39:292-301 «PMID: 23184037»PubMed
  136. Benhamou D, Girault C, Faure C ym. Nasal mask ventilation in acute respiratory failure. Experience in elderly patients. Chest 1992;102:912-7 «PMID: 1516421»PubMed
  137. Chu CM, Chan VL, Wong IW ym. Noninvasive ventilation in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease who refused endotracheal intubation. Crit Care Med 2004;32:372-7 «PMID: 14758150»PubMed
  138. Meduri GU, Fox RC, Abou-Shala N ym. Noninvasive mechanical ventilation via face mask in patients with acute respiratory failure who refused endotracheal intubation. Crit Care Med 1994;22:1584-90 «PMID: 7924369»PubMed
  139. Schettino G, Altobelli N, Kacmarek RM. Noninvasive positive pressure ventilation reverses acute respiratory failure in select "do-not-intubate" patients. Crit Care Med 2005;33:1976-82 «PMID: 16148468»PubMed
  140. Antonelli M, Conti G, Bufi M ym. Noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation: a randomized trial. JAMA 2000;283:235-41 «PMID: 10634340»PubMed
  141. Confalonieri M, Calderini E, Terraciano S ym. Noninvasive ventilation for treating acute respiratory failure in AIDS patients with Pneumocystis carinii pneumonia. Intensive Care Med 2002;28:1233-8 «PMID: 12209270»PubMed
  142. Gristina GR, Antonelli M, Conti G ym. Noninvasive versus invasive ventilation for acute respiratory failure in patients with hematologic malignancies: a 5-year multicenter observational survey. Crit Care Med 2011;39:2232-9 «PMID: 21666446»PubMed
  143. Hilbert G, Gruson D, Vargas F ym. Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N Engl J Med 2001;344:481-7 «PMID: 11172189»PubMed
  144. Molina R, Bernal T, Borges M ym. Ventilatory support in critically ill hematology patients with respiratory failure. Crit Care 2012;16:R133 «PMID: 22827955»PubMed
  145. Razlaf P, Pabst D, Mohr M ym. Non-invasive ventilation in immunosuppressed patients with pneumonia and extrapulmonary sepsis. Respir Med 2012;106:1509-16 «PMID: 22944604»PubMed
  146. Bellone A, Monari A, Cortellaro F ym. Myocardial infarction rate in acute pulmonary edema: noninvasive pressure support ventilation versus continuous positive airway pressure. Crit Care Med 2004;32:1860-5 «PMID: 15343013»PubMed
  147. Bellone A, Vettorello M, Monari A ym. Noninvasive pressure support ventilation vs. continuous positive airway pressure in acute hypercapnic pulmonary edema. Intensive Care Med 2005;31:807-11 «PMID: 15871011»PubMed
  148. Crane SD, Elliott MW, Gilligan P ym. Randomised controlled comparison of continuous positive airways pressure, bilevel non-invasive ventilation, and standard treatment in emergency department patients with acute cardiogenic pulmonary oedema. Emerg Med J 2004;21:155-61 «PMID: 14988338»PubMed
  149. Mehta S, Jay GD, Woolard RH ym. Randomized, prospective trial of bilevel versus continuous positive airway pressure in acute pulmonary edema. Crit Care Med 1997;25:620-8 «PMID: 9142026»PubMed
  150. Park M, Lorenzi-Filho G, Feltrim MI ym. Oxygen therapy, continuous positive airway pressure, or noninvasive bilevel positive pressure ventilation in the treatment of acute cardiogenic pulmonary edema. Arq Bras Cardiol 2001;76:221-30 «PMID: 11262572»PubMed
  151. Park M, Sangean MC, Volpe Mde S ym. Randomized, prospective trial of oxygen, continuous positive airway pressure, and bilevel positive airway pressure by face mask in acute cardiogenic pulmonary edema. Crit Care Med 2004;32:2407-15 «PMID: 15599144»PubMed
  152. Burns KE, Adhikari NK, Slutsky AS ym. Pressure and volume limited ventilation for the ventilatory management of patients with acute lung injury: a systematic review and meta-analysis. PLoS One 2011;6:e14623 «PMID: 21298026»PubMed
  153. Petrucci N, Iacovelli W. Ventilation with lower tidal volumes versus traditional tidal volumes in adults for acute lung injury and acute respiratory distress syndrome. Cochrane Database Syst Rev 2003;(3):CD003844 «PMID: 12917991»PubMed
  154. Phoenix SI, Paravastu S, Columb M ym. Does a higher positive end expiratory pressure decrease mortality in acute respiratory distress syndrome? A systematic review and meta-analysis. Anesthesiology 2009;110:1098-105 «PMID: 19352160»PubMed
  155. Putensen C, Theuerkauf N, Zinserling J ym. Meta-analysis: ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury. Ann Intern Med 2009;151:566-76 «PMID: 19841457»PubMed
  156. Esteban A, Alía I, Gordo F ym. Prospective randomized trial comparing pressure-controlled ventilation and volume-controlled ventilation in ARDS. For the Spanish Lung Failure Collaborative Group. Chest 2000;117:1690-6 «PMID: 10858404»PubMed
  157. Jongerden IP, Rovers MM, Grypdonck MH ym. Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: a meta-analysis. Crit Care Med 2007;35:260-70 «PMID: 17133187»PubMed
  158. Overend TJ, Anderson CM, Brooks D ym. Updating the evidence-base for suctioning adult patients: a systematic review. Can Respir J 2009;16:e6-17 «PMID: 19557211»PubMed
  159. Siempos II, Vardakas KZ, Falagas ME. Closed tracheal suction systems for prevention of ventilator-associated pneumonia. Br J Anaesth 2008;100:299-306 «PMID: 18250225»PubMed
  160. Subirana M, Solà I, Benito S. Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients. Cochrane Database Syst Rev 2007;(7):CD004581 «PMID: 17943823»PubMed
  161. Brook AD, Ahrens TS, Schaiff R ym. Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. Crit Care Med 1999;27:2609-15 «PMID: 10628598»PubMed
  162. Bucknall TK, Manias E, Presneill JJ. A randomized trial of protocol-directed sedation management for mechanical ventilation in an Australian intensive care unit. Crit Care Med 2008;36:1444-50 «PMID: 18434914»PubMed
  163. Girard TD, Kress JP, Fuchs BD ym. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet 2008;371:126-34 «PMID: 18191684»PubMed
  164. Kress JP, Pohlman AS, O'Connor MF ym. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000;342:1471-7 «PMID: 10816184»PubMed
  165. Dunham CM, Ransom KJ. Assessment of early tracheostomy in trauma patients: a systematic review and meta-analysis. Am Surg 2006;72:276-81 «PMID: 16553133»PubMed
  166. Gomes Silva BN, Andriolo RB, Saconato H ym. Early versus late tracheostomy for critically ill patients. Cochrane Database Syst Rev 2012;3:CD007271 «PMID: 22419322»PubMed
  167. Griffiths J, Barber VS, Morgan L ym. Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. BMJ 2005;330:1243 «PMID: 15901643»PubMed
  168. Rumbak MJ, Newton M, Truncale T ym. A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Crit Care Med 2004;32:1689-94 «PMID: 15286545»PubMed
  169. Alexiou VG, Ierodiakonou V, Dimopoulos G ym. Impact of patient position on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials. J Crit Care 2009;24:515-22 «PMID: 19327314»PubMed
  170. Niël-Weise BS, Gastmeier P, Kola A ym. An evidence-based recommendation on bed head elevation for mechanically ventilated patients. Crit Care 2011;15:R111 «PMID: 21481251»PubMed
  171. Abroug F, Ouanes-Besbes L, Dachraoui F ym. An updated study-level meta-analysis of randomised controlled trials on proning in ARDS and acute lung injury. Crit Care 2011;15:R6 «PMID: 21211010»PubMed
  172. Sud S, Friedrich JO, Taccone P ym. Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med 2010;36:585-99 «PMID: 20130832»PubMed
  173. Adhikari NK, Burns KE, Friedrich JO ym. Effect of nitric oxide on oxygenation and mortality in acute lung injury: systematic review and meta-analysis. BMJ 2007;334:779 «PMID: 17383982»PubMed
  174. Afshari A, Brok J, Møller AM ym. Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults. Cochrane Database Syst Rev 2010;(7):CD002787 «PMID: 20614430»PubMed
  175. Morris AH, Wallace CJ, Menlove RL ym. Randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome. Am J Respir Crit Care Med 1994;149:295-305 «PMID: 8306022»PubMed
  176. Peek GJ, Elbourne D, Mugford M ym. Randomised controlled trial and parallel economic evaluation of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR). Health Technol Assess 2010;14:1-46 «PMID: 20642916»PubMed
  177. Zangrillo A, Biondi-Zoccai G, Landoni G ym. Extracorporeal membrane oxygenation (ECMO) in patients with H1N1 influenza infection: a systematic review and meta-analysis including 8 studies and 266 patients receiving ECMO. Crit Care 2013;17:R30 «PMID: 23406535»PubMed
  178. Blackwood B, Alderdice F, Burns KE, Cardwell CR, Lavery G, O´Halloran P. Protocolized versus non-ptotocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Syst Rev 2011;(7):CD006904;
  179. Butler R, Keenan SP, Inman KJ ym. Is there a preferred technique for weaning the difficult-to-wean patient? A systematic review of the literature. Crit Care Med 1999;27:2331-6 «PMID: 10579244»PubMed
  180. Esteban A, Alía I, Gordo F ym. Extubation outcome after spontaneous breathing trials with T-tube or pressure support ventilation. The Spanish Lung Failure Collaborative Group. Am J Respir Crit Care Med 1997;156:459-65 «PMID: 9279224»PubMed
  181. Esteban A, Alía I, Tobin MJ ym. Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group. Am J Respir Crit Care Med 1999;159:512-8 «PMID: 9927366»PubMed
  182. Esteban A, Frutos F, Tobin MJ ym. A comparison of four methods of weaning patients from mechanical ventilation. Spanish Lung Failure Collaborative Group. N Engl J Med 1995;332:345-50 «PMID: 7823995»PubMed
  183. Vallverdú I, Calaf N, Subirana M ym. Clinical characteristics, respiratory functional parameters, and outcome of a two-hour T-piece trial in patients weaning from mechanical ventilation. Am J Respir Crit Care Med 1998;158:1855-62 «PMID: 9847278»PubMed
  184. Girault C, Bubenheim M, Abroug F ym. Noninvasive ventilation and weaning in patients with chronic hypercapnic respiratory failure: a randomized multicenter trial. Am J Respir Crit Care Med 2011;184:672-9 «PMID: 21680944»PubMed
  185. Glossop AJ, Shephard N, Bryden DC ym. Non-invasive ventilation for weaning, avoiding reintubation after extubation and in the postoperative period: a meta-analysis. Br J Anaesth 2012;109:305-14 «PMID: 22879654»PubMed
  186. Esteban A, Frutos-Vivar F, Ferguson ND ym. Noninvasive positive-pressure ventilation for respiratory failure after extubation. N Engl J Med 2004;350:2452-60 «PMID: 15190137»PubMed
  187. Keenan SP, Powers C, McCormack DG ym. Noninvasive positive-pressure ventilation for postextubation respiratory distress: a randomized controlled trial. JAMA 2002;287:3238-44 «PMID: 12076220»PubMed
  188. Agarwal R, Nath A, Aggarwal AN ym. Do glucocorticoids decrease mortality in acute respiratory distress syndrome? A meta-analysis. Respirology 2007;12:585-90 «PMID: 17587427»PubMed
  189. Lamontagne F, Briel M, Guyatt GH ym. Corticosteroid therapy for acute lung injury, acute respiratory distress syndrome, and severe pneumonia: a meta-analysis of randomized controlled trials. J Crit Care 2010;25:420-35 «PMID: 19896324»PubMed
  190. Meduri GU, Marik PE, Chrousos GP ym. Steroid treatment in ARDS: a critical appraisal of the ARDS network trial and the recent literature. Intensive Care Med 2008;34:61-9 «PMID: 18000649»PubMed
  191. Peter JV, John P, Graham PL ym. Corticosteroids in the prevention and treatment of acute respiratory distress syndrome (ARDS) in adults: meta-analysis. BMJ 2008;336:1006-9 «PMID: 18434379»PubMed
  192. Steinberg KP, Hudson LD, Goodman RB ym. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med 2006;354:1671-84 «PMID: 16625008»PubMed
  193. Clermont G, Kong L, Weissfeld LA ym. The effect of pulmonary artery catheter use on costs and long-term outcomes of acute lung injury. PLoS One 2011;6:e22512 «PMID: 21811626»PubMed
  194. National Heart, Lung and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wheeler AP, Bernard GR ym. Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med 2006;354:2213-24 «PMID: 16714768»PubMed
  195. Rosenberg AL, Dechert RE, Park PK ym. Review of a large clinical series: association of cumulative fluid balance on outcome in acute lung injury: a retrospective review of the ARDSnet tidal volume study cohort. J Intensive Care Med 2009;24:35-46 «PMID: 19103612»PubMed
  196. Stewart RM, Park PK, Hunt JP ym. Less is more: improved outcomes in surgical patients with conservative fluid administration and central venous catheter monitoring. J Am Coll Surg 2009;208:725-35; discussion 735-7 «PMID: 19476825»PubMed
  197. Hess DR. And now for the rest of the story (letter). Respir Care 2002;47:696-9
  198. Lellouche F, Taillé S, Lefrançois F ym. Humidification performance of 48 passive airway humidifiers: comparison with manufacturer data. Chest 2009;135:276-86 «PMID: 19201708»PubMed
  199. Siempos II, Vardakas KZ, Kopterides P ym. Impact of passive humidification on clinical outcomes of mechanically ventilated patients: a meta-analysis of randomized controlled trials. Crit Care Med 2007;35:2843-51 «PMID: 18074484»PubMed
  200. Parke RL, McGuinness SP, Eccleston ML. A preliminary randomized controlled trial to assess effectiveness of nasal high-flow oxygen in intensive care patients. Respir Care 2011;56:265-70 «PMID: 21255498»PubMed
  201. Roca O, Riera J, Torres F ym. High-flow oxygen therapy in acute respiratory failure. Respir Care 2010;55:408-13 «PMID: 20406507»PubMed
  202. Sztrymf B, Messika J, Bertrand F ym. Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. Intensive Care Med 2011;37:1780-6 «PMID: 21946925»PubMed
  203. Carrillo A, Ferrer M, Gonzalez-Diaz G ym. Noninvasive ventilation in acute hypercapnic respiratory failure caused by obesity hypoventilation syndrome and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012;186:1279-85 «PMID: 23103736»PubMed
  204. Gursel G, Aydogdu M, Gulbas G ym. The influence of severe obesity on non-invasive ventilation (NIV) strategies and responses in patients with acute hypercapnic respiratory failure attacks in the ICU. Minerva Anestesiol 2011;77:17-25 «PMID: 21273965»PubMed
  205. Marik PE, Desai H. Characteristics of patients with the "malignant obesity hypoventilation syndrome" admitted to an ICU. J Intensive Care Med 2013;28:124-30 «PMID: 22564878»PubMed
  206. Piper AJ, Grunstein RR. Obesity hypoventilation syndrome: mechanisms and management. Am J Respir Crit Care Med 2011;183:292-8 «PMID: 21037018»PubMed
  207. Alhazzani W, Alshahrani M, Jaeschke R ym. Neuromuscular blocking agents in acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials. Crit Care 2013;17:R43 «PMID: 23497608»PubMed
  208. Anifantaki S, Prinianakis G, Vitsaksaki E ym. Daily interruption of sedative infusions in an adult medical-surgical intensive care unit: randomized controlled trial. J Adv Nurs 2009;65:1054-60 «PMID: 19399980»PubMed
  209. de Wit M, Gennings C, Jenvey WI ym. Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients. Crit Care 2008;12:R70 «PMID: 18492267»PubMed
  210. Mehta S, Burry L, Cook D ym. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial. JAMA 2012;308:1985-92 «PMID: 23180503»PubMed