For patients with moderate/severe ARDS (PF ratio<20 kPa), prone positioning was recommended for at least 12 hours per day. Where mechanical ventilation is required, the use of low tidal volumes (<6 ml/kg ideal body weight) and airway pressures (plateau pressure <30 cmH 2O) was recommended. The British Thoracic Society supports the recommendations in this guideline. The Faculty of Intensive Care Medicine and Intensive Care Society Guideline Development Group have used GRADE methodology to make the following recommendations for the management of adult patients with acute respiratory distress syndrome (ARDS). Correspondence to Professor Mark J D Griffiths.9 Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.8 Intensive Care, Heath Hospital, Cardiff, UK.7 Division of Infection,Immunity and Respiratory Medicine,NIHR Biomedical Research Centre, University of Manchester, Manchester, Greater Manchester, UK.6 Respiratory Medicine, King's College London, London, UK.5 Academic Department of Critical Care, QueenAlexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK.4 Critical Care, Saint Thomas' Hospital, London, UK.3 Warwick Clinical Trials Unit, University of Warwick, Coventry, West Midlands, UK.2 Wellcome-Wolfson Institute for Experimental Medicine, Queens University Belfast, Belfast, UK.1 Peri-Operative Medicine, Barts Health NHS Trust, London, UK.
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