Evidence map›Paper›PMID 42611192›Full record

ReviewIntensive care medicine2026

ARDS management beyond the guidelines: a practical physiology-based approach to individualized care.

Nattapat Wongtirawit, Luca Salvatore Menga, Roberto Brito, Mattia Docci, Glauco M Plens, Glasiele Alcala, Ben Cantan, Karen J Bosma, Matthew Ko, Georgiana Roman-Sarita and 4 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Nattapat Wongtirawit *Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Luca Salvatore Menga *Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Roberto BritoKeenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Mattia DocciKeenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Glauco M PlensDivision of Respirology and Critical Care, Department of Medicine, University Health Network, Toronto, Canada.
Glasiele AlcalaDivision of Respirology and Critical Care, Department of Medicine, University Health Network, Toronto, Canada.
Ben CantanInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
Karen J BosmaCritical Care Western, Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.
Matthew KoKeenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Georgiana Roman-SaritaDepartment of Respiratory Therapy, Toronto General Hospital, Toronto, Canada.
Trinity PurcellKeenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Davide Raimondi CominesiKeenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Richard A GreendykDivision of Respirology and Critical Care, Department of Medicine, University Health Network, Toronto, Canada.
Laurent BrochardKeenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada. laurent.brochard@unityhealth.to.ORCID http://orcid.org/0000-0002-7456-906X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Practice guidelines for acute respiratory distress syndrome (ARDS) have established lung-protective ventilation as the standard of care, but optimized management requires further individualization to each patient's specific physiological characteristics and response to treatment. Beyond guidelines-level targets, clinicians must answer numerous practical bedside questions from how to start ventilating a newly intubated patient, to what to do when the driving pressure target is not met, and how to assess recruitability and set positive end expiratory pressure (PEEP). Integrating ventilator management with gas exchange and hemodynamic targets requires further careful consideration. Managing sedation to the patient's respiratory drive and effort, and its crucial role during the transition from controlled to assisted ventilation, poses additional complexity. This narrative review addresses these questions through recent physiological advances and translates them into practical strategies that inform decisions at bedside.

Indexed as

Precision MedicineRespiration, ArtificialRespiratory Distress SyndromeHumansPositive-Pressure RespirationPractice Guidelines as TopicAcute respiratory distress syndromeDriving pressureLung recruitabilityMechanical ventilationPositive end-expiratory pressureRespiratory drive

Identifiers

PMID42611192

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.