On the S3 guidelines on invasive ventilation and use of extracorporeal procedures in acute respiratory insufficiency

In intensive care units (ICU) invasive ventilation of patients has been aregularly used intervention for more than 50 years. Modern intensive care medicine as we know it today, is characterized by the optimal implementation of the potentially life-sustaining therapy option ventilation. Although the prognosis of invasively ventilated, critically ill patients is decisively determined by the underlying disease or injury, the ventilation itself can produce damaging or even lethal effects. Previously applied ventilation settings can be the cause of ventilator-associated lung injury, resulting in increased mortality for patients in the ICU.In particular, the heterogeneity of clinical care also concerns the extracorporeal procedures used, such as extracorporeal membrane oxygenation (ECMO). In recent years, technical advances have led to aconsiderable but also sometimes uncritical spread of these methods, without any definite additional benefit for the individual patient being expected in every case. Therefore, the goal was to develop S3 guidelines with the participation of German, Austrian and Swiss scientific societies, to provide an evidence-based source of information and decision-making support for the care of patients with acute respiratory insufficiency as well as the clinical issues associated with invasive ventilation and extracorporeal procedures