ARDS (Joint committee of 3 Japanese societies) We suggest conducting non-invasive respiratory support (NPPV, HFNC) instead of conventional oxygen therapy as an initial respiratory management for adult patients with acute respiratory failure suspected of having ARDS if there are no contraindications for non-invasive respiratory support or if organ failure other than respiratory failure is absent. NPPV (weak recommendation/moderate certainty of evidence: GRADE 2B). HFNC (weak recommendation/moderate certainty of evidence: GRADE 2B).Recommendation (CQ 16).ARDS Clinical Practice Guideline 2021 committee from the Japanese Society of Intensive Care Medicine, the Japanese Respiratory Society, and the Japanese Society of Respiratory Care Medicine. RECOMMENDATION based on scientific experience. Avoid escalation (AARC) NHF is preferred to COT to avoid escalation to NIV or IV in patients who require supplemental oxygen.Post-extubation respiratory failure (ESICM): NHF is preferred to COT following extubation in patients with any high-risk feature who were intubated for >24 hours.Thoracic Society of Australia and New Zealand Position Statement on Acute Oxygen Use in Adults: 'Swimming between the flags'. Appropriate Use of High-Flow Nasal Oxygen in Hospitalized Patients for Initial or Postextubation Management of Acute Respiratory Failure: A Clinical Guideline From the American College of Physicians. AARC: Piraino et al. Management of Adult Patients With Oxygen in the Acute Care Setting.Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure. ESICM: Rochwerg et al. The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline.Post-extubation respiratory failure (ESICM): NIPPV is preferred to NHF in patients who would normally be extubated to NIPPV.Post‑operative (ERS): Either NHF or NIV can be used in postoperative patients at high risk of respiratory complications.Oxygen delivery (TSANZ): hNHF-O2 may be used in patients with acute, severe, hypoxaemic respiratory failure (Grade B) 35178831.Post‑extubation (ACP): NHF is preferred to COT in patients with post-extubation AHRF. CONDITIONAL RECOMMENDATION.Acute hypoxemic respiratory failure (ACP): NHF is preferred to NIV in patients with AHRF.General recommendations for the delivery of supplemental oxygen for patients who require oxygen (AARC). Aim for SpO2 range of 94–98% for most of hospitalized patients (included critically ill patients) - Aim for 88–92% for patients with COPD - Aim for 88–95% for patients with ARDS - Consider early initiation of NHF. RECOMMENDATION.
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