ATS GUIDELINES Bundle

Acute Respiratory Failure

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Table 1. Recommendations for Actionable PICO Questions Clinical indication a Certainty of evidence b Strength of Recommendation Prevention of hypercapnia in COPD exacerbation ⊕⊕ Conditional against Hypercapnia with COPD exacerbation ⊕⊕⊕⊕ Strong for Cardiogenic pulmonary oedema ⊕⊕⊕ Strong for Acute asthma exacerbation No recommendation made Immunocompromised ⊕⊕⊕ Conditional for De novo respiratory failure No recommendation made Post-operative patients ⊕⊕⊕ Conditional for Palliative care ⊕⊕⊕ Conditional for Trauma ⊕⊕⊕ Conditional for Pandemic viral illness No recommendation made Post-extubation in high-risk patients c (prophylaxis) ⊕⊕ Conditional for Post-extubation respiratory failure d ⊕⊕ Conditional against Weaning in hypercapnic patients ⊕⊕⊕ Conditional for a All in the setting of acute respiratory failure b Certainty of effect estimates: ⊕⊕⊕⊕ , high; ⊕⊕⊕ , moderate; ⊕⊕ , low; ⊕ , very low. c Patients with unplanned extubation are a higher risk group and further studies are needed to address the use of NIV in this group. d is recommendation may not apply to post-extubation CHF or COPD patients with respiratory failure; further studies are needed.

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