Acute respiratory failureMANAGEMENT

RESPIRATORY PRESENTATIONS · 12 SECTIONS

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634 items

☷ Legend

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Cardiovascular Presentations66▾

Respiratory Presentations47▾

Acute bronchitis Acute Respiratory Distress Syndrome (ARDS)Acute respiratory failure Apparent Life-Threatening Event (ALTE-BRUE)Aspiration pneumonia Asthma exacerbation Bacterial Tracheitis Bronchiolitis Bronchiolitis (RSV)Chylothorax Community-acquired pneumonia COPD exacerbation COVID-19 pneumonia Croup Croup (laryngotracheobronchitis)Cystic Fibrosis Exacerbation Empyema Epiglottitis Epiglottitis (Pediatric)Fat Embolism Syndrome Foreign Body Aspiration Foreign Body Aspiration (Pediatric)Healthcare-Associated Pneumonia Hemothorax Hospital-acquired pneumonia Legionnaires' Disease Lung Abscess Pertussis Pleural effusion Pleurisy Pneumocystis jirovecii Pneumonia Pneumocystis Pneumonia Pneumomediastinum Pneumothorax (Simple)Pneumothorax (traumatic)Psittacosis Pulmonary Alveolar Proteinosis Pulmonary contusion Pulmonary Edema (Non-cardiogenic)Sarcoidosis Exacerbation Smoke Inhalation Injury Spontaneous pneumothorax Status Asthmaticus Sudden Infant Death Syndrome (SIDS)Tension Pneumothorax Tracheal Stenosis Viral Pneumonia

Neurological Presentations77▾

Gastrointestinal Presentations63▾

Genitourinary and Reproductive Presentations44▾

Infectious Disease Presentations146▾

Trauma Presentations88▾

Toxicologic Presentations67▾

Psychiatric Presentations25▾

Musculoskeletal and Rheumatologic Presentations89▾

Dermatology Presentations21▾

Environmental and Exposure Presentations26▾

Hematologic and Oncologic Presentations30▾

Pediatric-Specific Presentations13▾

Endocrine and Metabolic Presentations42▾

ENT and Maxillofacial Presentations21▾

Ophthalmologic Presentations15▾

Obstetric Presentations17▾

Systemic and Miscellaneous Presentations15▾

01Approach to the Critical Patient/attcp85

Immediate Priorities

›Stabilization priorities

›Airway patency and protection risk

›GCS < 8

›Copious secretions

›Refractory hypoxemia

›Severe hypercapnia with acidemia

›Breathing status

›SpO2 target strategy by risk group

›Most patients 92% to 96%

›COPD or chronic hypercapnia risk 88% to 92%

›Carbon monoxide poisoning target 100% after high flow oxygen

›Work of breathing severity

›Accessory muscle use

›Paradoxical breathing

›Inability to speak full sentences

›Circulation threats

›Shock signs

›SBP < 90 mmHg or MAP < 65 mmHg

›Altered mental status

›Mottling

›Immediate monitoring

›Continuous pulse oximetry

›Poor waveform as unreliable reading trigger

›Low perfusion state as unreliable reading trigger

›Cardiac monitoring

›Dysrhythmia trigger for airway escalation

›Noninvasive blood pressure cycling

›Q3 to Q5 minute frequency in unstable patient

›End tidal CO2 if ventilatory support

›Rising ETCO2 as hypoventilation marker

›Escalation triggers

›Resuscitation bay activation

›SpO2 < 90% despite nonrebreather

›RR > 35 breaths per minute with fatigue

›pH < 7.25 with rising PaCO2

›Immediate airway team activation

›Apnea

›Severe agitation or obtundation preventing mask therapy

›Hemodynamic collapse

Oxygenation and Ventilation Strategy

›Stepwise support selection

›Standard oxygen

›Nasal cannula 1 to 6 L/min

›Simple mask 6 to 10 L/min

›Nonrebreather 10 to 15 L/min

›High flow nasal cannula

›Hypoxemic respiratory failure with intact airway reflexes

›Initial flow 40 to 60 L/min

›FiO2 titration to SpO2 target

›Noninvasive ventilation

›COPD exacerbation with hypercapnic acidemia

›Cardiogenic pulmonary edema

›Obesity hypoventilation with acute on chronic hypercapnia

›Endotracheal intubation and invasive ventilation

›Failure of HFNC or NIV

›Inability to protect airway

›Severe ARDS with refractory hypoxemia

Key Concepts

›Definitions and coding

›Acute respiratory failure with hypoxemia

›ICD-10 J96.01

›SNOMED CT 409622000

›Acute respiratory failure with hypercapnia

›ICD-10 J96.02

›SNOMED CT 409623005

›Acute respiratory failure with hypoxia and hypercapnia

›ICD-10 J96.00 with supporting gas data

›Physiologic patterns

›Hypoxemic failure

›VQ mismatch

›Shunt physiology

›Diffusion limitation

›Hypercapnic failure

›Alveolar hypoventilation

›Increased dead space ventilation

›Impending fatigue pattern

›Rising PaCO2 with falling RR

›Diminishing tidal volumes

PITFALLS

›Common errors

›Over oxygenation in chronic CO2 retainers with loss of hypoxic drive risk

›Target SpO2 88% to 92% when COPD or chronic hypercapnia risk

›Delayed intubation after clear NIV failure

›Worsening mental status

›Persistent acidemia after 1 to 2 hours NIV

›Unrecognized pneumothorax during positive pressure support

›Sudden hypotension

›Unilateral breath sound decrease

02History/hx58

Presenting Pattern

›Symptom timeline and trajectory

›Onset time

›Sudden onset minutes

›Subacute hours

›Progressive days

›Triggering event

›Aspiration

›Allergen exposure

›Viral prodrome

›Exertion

›Primary symptom cluster

›Dyspnea

›At rest

›Exertional

›Orthopnea

›Cough

›Productive

›Hemoptysis

›Chest symptoms

›Pleuritic pain

›Chest tightness

›Functional impact

›Speaking full sentences limitation

›Unable to ambulate without stopping

Risk Factors and Exposures

›Pulmonary history

›Asthma

›COPD

›Interstitial lung disease

›Obstructive sleep apnea

›Cardiac history

›Heart failure

›Coronary disease

›Valvular disease

›Thromboembolic risk

›Recent surgery or immobilization

›Prior DVT or PE

›Estrogen therapy

›Malignancy

›Infectious risk

›Sick contacts

›Immunosuppression

›Recent antibiotics

›Travel and exposure clusters

›Toxic and environmental exposure

›Smoke inhalation

›Carbon monoxide exposure

›Occupational dusts

Medications and Devices

›Current therapies

›Home oxygen use

›Inhaler adherence

›Diuretics

›Sedating substances

›Opioids

›Benzodiazepines

›Alcohol

›Airway device history

›Tracheostomy

›Home NIV or CPAP

03Physical Exam/exam45

General and Vitals

›Severity markers

›Respiratory rate

›RR > 30 breaths per minute as severe marker

›Declining RR with worsening mentation as fatigue marker

›Oxygen saturation on room air and support level

›SpO2 < 90% on high flow oxygen as severe marker

›Mental status

›Agitation from hypoxemia

›Somnolence from hypercapnia

›Work of breathing

›Accessory muscle use

›Nasal flaring

›Intercostal retractions

›Tripod positioning

Pulmonary Exam

›Breath sounds

›Diffuse wheeze

›Asthma or COPD pattern

›Focal crackles

›Pneumonia pattern

›Diffuse crackles

›Pulmonary edema or ARDS pattern

›Unilateral decreased breath sounds

›Pneumothorax or large effusion pattern

›Percussion and fremitus

›Hyperresonance unilateral

›Dullness at bases

Cardiovascular and Volume

›Heart failure markers

›JVP elevation

›S3 gallop

›Peripheral edema

›Shock markers

›Cool clammy skin

›Delayed capillary refill

Focused Exam for Causes

›Upper airway obstruction clues

›Stridor

›Voice change

›Drooling

›DVT signs

›Unilateral leg swelling

›Calf tenderness

PITFALLS

›Misleading findings

›Quiet chest in severe asthma

›Minimal wheeze with severe airflow limitation

›Normal lung exam in pulmonary embolism

›Disproportionate dyspnea and tachycardia

04Differential Diagnosis/ddx43

Life Threats

›Immediate threats

›Pulmonary embolism

›ICD-10 I26.99

›SNOMED CT 59282003

›Tension pneumothorax

›ICD-10 J93.0

›SNOMED CT 233783004

›Acute cardiogenic pulmonary edema

›ICD-10 I50.1

›SNOMED CT 417996009

›Status asthmaticus

›ICD-10 J45.902

›SNOMED CT 426656000

›Severe COPD exacerbation

›ICD-10 J44.1

›SNOMED CT 195951007

Common Etiologies by Pattern

›Hypoxemic predominant

›Pneumonia

›Community acquired pneumonia ICD-10 J18.9

›ARDS

›ICD-10 J80

›Berlin criteria alignment

›Aspiration pneumonitis or pneumonia

›ICD-10 J69.0

›Atelectasis

›ICD-10 J98.11

›Hypercapnic predominant

›COPD exacerbation

›Severe asthma

›Obesity hypoventilation syndrome

›Neuromuscular weakness

›Myasthenic crisis

›Guillain Barre syndrome

›CNS depression

›Opioid toxicity

›Sedative hypnotic toxicity

Mimics and Mixed

›Mixed cardiopulmonary

›COPD plus heart failure

›Pneumonia plus sepsis related vasodilation

›Metabolic drivers

›Severe metabolic acidosis with compensatory tachypnea

›DKA

›Sepsis lactic acidosis

05Laboratory Tests/lt36

Core Tests

›Baseline laboratory panel

›Complete blood count for infection or anemia

›Leukocytosis context for bacterial infection

›Hemoglobin low as dyspnea contributor

›Electrolytes and renal function for medication safety

›Potassium for beta agonist and diuretic effects

›Creatinine for contrast planning

›Venous blood gas for ventilation and acid base screening

›pH trend as severity marker

›PCO2 trend as hypoventilation marker

›Arterial blood gas when precise oxygenation needed

›PaO2 for PFR calculation

›A-a gradient consideration when on known FiO2

Cause Directed Tests

›Infection evaluation

›Lactate in suspected sepsis

›Lactate mmol/l interpretation in perfusion context

›Blood cultures in septic shock or severe pneumonia before antibiotics when feasible

›Respiratory viral testing when results change isolation or antivirals

›Procalcitonin as adjunct when uncertainty about bacterial infection

›Cardiac evaluation

›Troponin for ischemia or strain pattern

›BNP or NT-proBNP for heart failure support

›Thromboembolism evaluation

›D-dimer in low to intermediate pretest probability PE pathway

›Age adjusted threshold consideration in adults

Toxicology and Special

›Carbon monoxide and smoke exposure

›Carboxyhemoglobin level

›Pulse oximetry falsely normal risk

›Lactate for cyanide concern in smoke inhalation

›Medication related hypoventilation

›Acetaminophen level when overdose possible

›Salicylate level when acid base pattern suggests

PITFALLS

›Lab limitations

›Normal lactate does not exclude sepsis early

›Venous PCO2 may underestimate arterial PCO2 in shock

›D-dimer elevation nonspecific in infection and pregnancy

06Diagnostic Tests/dt59

Scoring Systems

›Risk stratification and monitoring scores

›ROX index for HFNC failure prediction

›ROX definition SpO2 FiO2 divided by RR

›Higher ROX associated with lower intubation risk

›Serial ROX at 2 hours and 6 hours for trend

›HACOR score for NIV failure risk

›Components heart rate

›Components acidosis

›Components consciousness

›Components oxygenation

›Components respiratory rate

›CURB-65 for pneumonia severity in adults

›Confusion

›Urea mmol/l threshold local lab reference mapping

›Respiratory rate threshold

›Blood pressure threshold

›Age 65 or older

›PESI or sPESI for PE risk in adults

›Hemodynamic stability marker

›Comorbidity burden marker

MRI

›Indications

›Spinal cord pathology with hypoventilation pattern

›Cervical myelopathy suspicion

›Brainstem stroke with central hypoventilation suspicion

›Posterior circulation syndrome

›Limitations

›Unstable patient incompatibility

›Time to imaging delay

›Limited role in primary pulmonary causes

›Chest CT applications

›CT pulmonary angiography for PE

›Moderate to high pretest probability

›Contrast nephropathy risk assessment

›CT chest for unclear hypoxemia

›Interstitial lung disease flare

›Occult pneumonia

›Complication evaluation

›Abscess

›Empyema

›CT contraindications and cautions

›Severe contrast allergy

›Renal dysfunction with risk benefit assessment

›Interpretation pearls

›Right heart strain signs in PE

›Diffuse ground glass and dependent consolidation in ARDS patterns

Ultrasound

›Point of care ultrasound

›Lung ultrasound profiles

›Diffuse B lines for interstitial edema pattern

›Focal B lines or consolidation for pneumonia pattern

›Lung sliding absence for pneumothorax concern

›Cardiac ultrasound

›LV function gross assessment for cardiogenic edema

›RV dilation for PE strain pattern

›Pericardial effusion with tamponade physiology

›IVC assessment as adjunct to volume status

›Collapsibility limitations in ventilated patients

›Procedure guidance

›Thoracentesis guidance for large effusion

›Vascular access guidance in shock

07Disposition/dispo37

Level of Care

›ICU indications

›Invasive mechanical ventilation

›NIV with high failure risk

›Persistent pH < 7.25

›Rising PaCO2

›Worsening mental status

›Refractory hypoxemia

›FiO2 > 0.6 to maintain SpO2 target

›Hemodynamic instability

›Vasopressor requirement

›Stepdown indications

›HFNC with improving ROX trend

›NIV stable with improving gases

›Ward with monitoring

›Low flow oxygen with stable vitals

›Clear etiology and response to therapy

Transfer and Consultation

›Specialist involvement triggers

›Critical care

›Escalating oxygen requirements

›Ventilator management complexity

›Cardiology

›Cardiogenic pulmonary edema

›Suspected ACS with respiratory failure

›Pulmonology

›Severe asthma or COPD

›Suspected ILD flare

›Anesthesia or airway team

›Anticipated difficult airway

›Transfer triggers

›ECMO capable center need

›Severe ARDS with refractory hypoxemia despite optimal ventilation

›Severe hypercapnia with unsafe airway pressures

Discharge Considerations

›Discharge eligibility

›Resolution of resting dyspnea

›SpO2 stable on room air or baseline home oxygen level

›Safe ambulation with stable saturation

›Clear outpatient plan and follow up

08Treatment/t165

Oxygen and Noninvasive Support

›Oxygen titration framework

›Target saturation selection

›Most patients 92% to 96%

›COPD or chronic hypercapnia risk 88% to 92%

›Device escalation path

›Nasal cannula

›Nonrebreather

›HFNC

›NIV

›Intubation

›High flow nasal cannula

›Setup and targets

›Flow 40 to 60 L/min

›Increase flow first for dyspnea and work of breathing

›Increase FiO2 for hypoxemia

›FiO2 titration to SpO2 target

›Reduce FiO2 to lowest effective once stable

›Noninvasive ventilation

›COPD hypercapnic exacerbation strategy

›BiPAP initial settings

›IPAP 10 to 15 cmH2O

›Titrate by 2 to 3 cmH2O every 5 to 10 minutes for ventilation

›EPAP 4 to 6 cmH2O

›Titrate for oxygenation and intrinsic PEEP offset

›Backup rate 10 to 16 breaths per minute when available

›Response targets

›Improved dyspnea within 30 to 60 minutes

›Rising pH on repeat gas

›Falling PaCO2 on repeat gas

›Cardiogenic pulmonary edema strategy

›CPAP 8 to 12 cmH2O

›If CPAP not tolerated then BiPAP with similar EPAP

›Adjunct diuresis and vasodilator pathway alignment

›Contraindications

›Vomiting or aspiration risk

›Inability to protect airway

›Facial trauma or recent upper airway surgery

›Hemodynamic instability

Airway and Intubation

›Indications for intubation

›Refractory hypoxemia on HFNC or NIV

›Severe hypercapnic acidemia

›pH < 7.20 with clinical fatigue

›Airway protection failure

›Inability to handle secretions

›Deteriorating mental status

›Preoxygenation

›NIV preoxygenation when feasible

›3 to 5 minutes with 100% FiO2

›Apneic oxygenation nasal cannula

›10 to 15 L/min during laryngoscopy

›RSI medications adult

›Induction agents

›Etomidate IV 0.3 mg/kg

›Hemodynamic neutrality preference

›Ketamine IV 1 to 2 mg/kg

›Bronchodilation benefit in asthma

›Caution severe hypertension or ischemia context

›Propofol IV 1 to 2 mg/kg

›Hypotension risk

›Paralytics

›Succinylcholine IV 1 to 1.5 mg/kg

›Contraindications

›Hyperkalemia

›Neuromuscular disease

›Major burns after 24 to 48 hours

›Rocuronium IV 1.2 mg/kg

›Longer paralysis duration planning

›Post intubation sedation and analgesia

›Analgesia first approach

›Fentanyl IV 25 to 100 mcg bolus

›Repeat every 5 minutes to comfort and ventilator synchrony

›Hydromorphone IV 0.5 to 1 mg bolus

›Repeat every 10 to 15 minutes as needed

›Sedation infusions

›Propofol IV infusion 10 to 50 mcg/kg/min

›Titrate every 5 minutes to target RASS

›Hypotension monitoring

›Dexmedetomidine IV infusion 0.2 to 1.5 mcg/kg/hr

›Bradycardia monitoring

›Midazolam IV infusion 1 to 10 mg/hr

›Delirium risk consideration

Mechanical Ventilation

›Lung protective ventilation for ARDS risk

›Tidal volume targets

›6 ml/kg predicted body weight

›Accept 4 to 8 ml/kg range based on plateau pressure

›Pressure limits

›Plateau pressure < 30 cmH2O

›Driving pressure minimization strategy

›PEEP strategy

›Moderate to high PEEP in moderate to severe ARDS

›Hemodynamic monitoring during PEEP escalation

›Oxygenation targets

›SpO2 88% to 95% in ARDS strategy

›PaO2 55 to 80 mmHg in ARDS strategy

›Obstructive lung disease ventilation

›Dynamic hyperinflation avoidance

›Lower RR strategy

›Prolonged expiratory time

›Permissive hypercapnia acceptance if pH acceptable

›PEEP setting

›Low external PEEP start 0 to 5 cmH2O

›Cautious titration for auto PEEP offset

Etiology Specific Therapies

›Asthma severe exacerbation

›Bronchodilators

›Salbutamol nebulized 5 mg

›Repeat every 20 minutes for 1 hour

›Continuous nebulization option 10 to 15 mg/hr

›Ipratropium nebulized 0.5 mg

›Repeat every 20 minutes for 1 hour

›Steroids

›Methylprednisolone IV 125 mg

›Alternative prednisone PO 50 mg when able

›Magnesium sulfate

›Magnesium sulfate IV 2 g over 20 minutes

›Hypotension monitoring

›Epinephrine for anaphylaxis or severe bronchospasm with poor air movement

›Epinephrine IM 0.3 to 0.5 mg of 1 mg/ml

›Repeat every 5 to 15 minutes as needed

›COPD exacerbation with hypercapnia

›Bronchodilators

›Salbutamol nebulized 2.5 to 5 mg

›Repeat every 20 minutes initially

›Ipratropium nebulized 0.5 mg

›Repeat every 4 to 6 hours

›Steroids

›Prednisone PO 40 mg daily

›Typical duration 5 days

›Methylprednisolone IV 40 to 60 mg if unable PO

›Antibiotics when indicated

›Increased sputum purulence

›Increased sputum volume

›Increased dyspnea

›Ventilatory support requirement

›Cardiogenic pulmonary edema

›Diuresis

›Furosemide IV 40 mg

›Higher initial dose if chronic loop diuretic use

›Vasodilator when hypertensive and not preload dependent

›Nitroglycerin IV infusion 10 to 200 mcg/min

›Titrate every 3 to 5 minutes to symptom and BP response

›Pneumonia and sepsis related respiratory failure

›Antibiotics within 1 hour for septic shock

›Local empiric pathway alignment

›Fluids and vasopressors as sepsis bundle

›Norepinephrine infusion 0.05 to 1 mcg/kg/min

›Titrate to MAP >= 65 mmHg

›Pulmonary embolism with respiratory failure

›Anticoagulation when no contraindication

›Unfractionated heparin infusion for high risk or planned procedures

›Thrombolysis consideration for massive PE with shock

›Alteplase systemic dosing per institutional protocol

›Opioid induced hypoventilation

›Naloxone titration

›Naloxone IV 0.04 mg

›Repeat every 2 minutes to adequate ventilation

›Avoid full withdrawal in chronic opioid use

Evidence and Recommendations

›Noninvasive ventilation in COPD hypercapnic exacerbation

›Reduced intubation and mortality in acidemic COPD exacerbation

›Strong recommendation in major society guidelines for appropriate candidates

›Lung protective ventilation in ARDS

›Lower tidal volume strategy associated with improved outcomes

›Class I recommendation based on critical care consensus for suspected ARDS

›Prone positioning in moderate to severe ARDS

›PaO2 FiO2 <= 150 mmHg on FiO2 >= 0.6 with PEEP >= 5 cmH2O as common threshold

›Class IIa recommendation based on ICU trials and guidelines

09Special Populations/sp34

Pregnancy

›Pregnancy considerations

›Physiologic changes

›Lower functional residual capacity

›Higher oxygen consumption

›Oxygenation targets

›SpO2 >= 95% typical fetal oxygenation goal

›Imaging

›PE algorithm with pregnancy adapted pathways

›Radiation risk counseling with CT or VQ decisions

›Medications

›Avoid teratogenic agents when alternatives exist

›Magnesium sulfate compatible when indicated

Geriatric

›Older adult considerations

›Atypical infection presentation

›Afebrile sepsis risk

›Lower physiologic reserve

›Earlier fatigue and decompensation

›Medication sensitivity

›Higher hypotension risk with sedatives

›Delirium risk with benzodiazepines

Pediatrics

›Pediatric considerations

›Age specific respiratory rate thresholds

›Tachypnea cutoffs by age band

›Weight based dosing

›Ketamine IV 1 to 2 mg/kg for RSI

›Rocuronium IV 1.2 mg/kg for RSI

›Common etiologies

›Bronchiolitis

›Croup and upper airway obstruction

›Asthma exacerbation

›Early escalation triggers

›Grunting

›Head bobbing

›Cyanosis

10Background/b39

Epidemiology

›Burden and settings

›Common ED and ICU syndrome rather than single diagnosis

›Frequent causes pneumonia

›Frequent causes heart failure

›Frequent causes COPD and asthma exacerbations

›High mortality subgroup

›ARDS and septic shock overlap

›Massive PE with shock

Pathophysiology

›Hypoxemia mechanisms

›VQ mismatch

›Pneumonia and COPD as common drivers

›Shunt

›Alveolar flooding in ARDS

›Atelectasis

›Diffusion limitation

›Interstitial lung disease

›Hypercapnia mechanisms

›Alveolar hypoventilation

›COPD with airflow limitation

›CNS depression

›Increased dead space

›Pulmonary embolism

›Work of breathing failure

›Respiratory muscle fatigue

›Sustained tachypnea

›Hyperinflation in obstructive disease

Therapeutic Considerations

›Oxygen as a drug

›Targeted saturation to avoid hypoxemia and hyperoxia harm

›COPD hypercapnia risk group with controlled oxygen strategy

›Positive pressure benefits

›Reduced work of breathing

›Improved alveolar recruitment

›Reduced preload and afterload in cardiogenic edema

›Risks of positive pressure

›Barotrauma and pneumothorax

›Hypotension from reduced venous return

›Ventilation targets

›Permissive hypercapnia in obstructive disease when needed to avoid high pressures

›Lung protective ventilation to reduce ventilator induced lung injury

11Patient Discharge Instructions/pdi19

Copy discharge instructions

›Discharge plan for resolved or mild respiratory failure causes

›Medications as prescribed

›Inhaler technique review

›Steroid course completion if given

›Antibiotic course completion if prescribed

›Home monitoring

›Worsening shortness of breath

›New chest pain

›Fever or rigors

›New confusion or severe sleepiness

›Return to ED immediately

›Trouble breathing at rest

›Lips or face turning blue or gray

›Fainting or severe weakness

›SpO2 below instructed threshold if home oximeter

›Follow up

›Primary care within 24 to 72 hours

›Pulmonology or cardiology when indicated

›Smoking cessation support if applicable

12References/r14

Clinical Guidelines and Evidence

›Society guidelines

›ATS ERS clinical practice guidelines on noninvasive ventilation for acute respiratory failure

›NIV recommended in acute hypercapnic COPD exacerbation with acidemia

›NIV recommended in cardiogenic pulmonary edema

›Surviving Sepsis Campaign guidelines

›Early antibiotics in septic shock

›Vasopressor target MAP >= 65 mmHg

›ARDS management guidelines and landmark trials

›Low tidal volume ventilation strategy

›Prone positioning in moderate to severe ARDS

›Decision tools and validation

›ROX index studies for HFNC monitoring

›HACOR score studies for NIV failure prediction

›Wells criteria and PERC for PE pathways in appropriate populations

Evidence & Review

Reviewed by SymptomDx Medical Team · Last reviewed June 16, 2026

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.