Society guidelines for pulmonary and critical care conditions.

10 topics · 14 versions · 4 high-yield

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ARDS

ards · society: ATS/ESICM/SCCM

2023 ESICM update of the 2017 ATS/ESICM/SCCM ARDS guideline covering adult patients and non-pharmacological respiratory support (plus neuromuscular blockade) for ARDS including COVID-19 ARDS. The guideline addresses 21 PICO questions across nine domains: definition, phenotyping, HFNO, NIV/CPAP, low tidal volume ventilation, PEEP and recruitment maneuvers, prone positioning, neuromuscular blockade, and extracorporeal life support. New since 2017: explicit recommendations for HFNO over conventional oxygen, awake prone positioning in COVID-19, against routine recruitment maneuvers, and stronger guidance on VV-ECMO in EOLIA-eligible patients.

Asthma ⭐

asthma · society: GINA · high-yield

GINA 2026 is the annual update of the Global Strategy for Asthma Management and Prevention, covering diagnosis, assessment, pharmacologic and non-pharmacologic management, exacerbations, severe asthma, and prevention across all ages. Key 2026 changes include four new exacerbation flowcharts with revised lower oxygen saturation thresholds (≥92%) and more conservative SABA dosing; addition of as-needed ICS-formoterol (AIR) and ICS-SABA options for children 6–11 years (CARE study) and adults (BATURA study); new biologics depemokimab (long-acting anti-IL5, q26-weekly) and biosimilar omalizumab-igec; expanded Step 5 LAMA options including budesonide-formoterol-glycopyrronium; and retention of the ≥12% and ≥200 mL FEV₁ criterion for bronchodilator responsiveness. Track 1 (ICS-formoterol as reliever, with or without maintenance) remains the preferred approach for adults/adolescents.

Community-acquired pneumonia ⭐

cap · society: ATS/IDSA · high-yield

2025 ATS/IDSA update to the 2019 CAP guideline addressing four focused questions in immunocompetent adults: lung ultrasound (LUS) as an alternative to chest radiography, empiric antibacterial therapy when a respiratory virus is detected, antibiotic duration shorter than 5 days after clinical stability, and adjunctive systemic corticosteroids in hospitalized CAP. Two questions are new (LUS, virus-positive empiric antibiotics) and two update 2019 recommendations (duration, steroids). The guideline emphasizes individualized care stratified by setting (outpatient vs inpatient) and severity (nonsevere vs severe CAP per 2007/2019 IDSA/ATS criteria); IDSA did not approve this update.

COPD ⭐

copd · society: GOLD · high-yield

GOLD 2026 is the 6th major revision of the global strategy for COPD diagnosis, management, and prevention. Key updates include lowering the threshold for GOLD group E to include even one moderate exacerbation, a new Disease Activity framework, clarified initial vs follow-up pharmacological algorithms, new biologic therapy guidance (dupilumab, mepolizumab), updated RSV/pneumococcal/influenza vaccination, completely revised exacerbation and multimorbidity chapters, and a new chapter on AI and emerging technologies. Diagnosis remains anchored on post-bronchodilator FEV1/FVC < 0.7 with active case-finding (not population screening) endorsed.

Hospital-acquired / ventilator-associated pneumonia

hap-vap · society: IDSA/ATS

The 2016 IDSA/ATS guideline addresses diagnosis and management of hospital-acquired pneumonia (HAP, non-ventilated) and ventilator-associated pneumonia (VAP) in adults, treating them as two distinct entities. Major changes from the 2005 version include adoption of GRADE methodology, elimination of the healthcare-associated pneumonia (HCAP) category, mandated use of local antibiograms to guide empiric therapy, 7-day treatment durations for most patients, and de-escalation strategies to limit unnecessary antibiotic use and resistance.

Idiopathic pulmonary fibrosis

ipf · society: ATS/ERS/JRS/ALAT

2022 ATS/ERS/JRS/ALAT guideline updates IPF diagnosis and management and introduces the new entity of progressive pulmonary fibrosis (PPF) in non-IPF fibrotic ILD. Key updates: transbronchial lung cryobiopsy (TBLC) is now an acceptable alternative to surgical lung biopsy in experienced centers; conditional recommendations against antacid medication and antireflux surgery for the sole purpose of improving respiratory outcomes in IPF; no recommendation on genomic classifier testing. PPF is defined by ≥2 of 3 criteria (symptoms, physiologic decline, radiologic progression) within 1 year, and nintedanib is conditionally recommended for PPF after failure of standard ILD-directed therapy, while pirfenidone requires further research.

Obstructive sleep apnea

osa · society: AASM

This document is the Bylaws of the American Academy of Sleep Medicine (updated January 2025), governing the corporate structure of the AASM as a Minnesota nonprofit. It is an organizational/governance document — not a clinical practice guideline — and contains no clinical recommendations, drug dosing, or diagnostic thresholds for sleep disorders. Content covers membership categories, Board of Directors composition and elections, Officer roles, and committee structure.

Pulmonary embolism / VTE (acute)

pe-vte-acute

Second update to the 9th edition CHEST guideline on antithrombotic therapy for VTE, providing 29 guidance statements (13 strong) across 17 PICO questions covering initial management, treatment-phase anticoagulation, extended-phase secondary prevention, and PTS prevention. Major changes from 2016 include strong preference for DOACs over VKA for treatment phase, preference for oral Xa inhibitors over LMWH in cancer-associated thrombosis, new guidance on cerebral vein thrombosis, antiphospholipid syndrome, reduced-dose DOACs for extended phase, and superficial vein thrombosis. New nomenclature defines three phases: initiation (5-21 days), treatment (3 months), and extended (no preplanned stop date).

Pulmonary hypertension

pulmonary-hypertension · society: ESC/ERS

Fourth-edition joint ESC/ERS guideline on diagnosis and treatment of pulmonary hypertension covering all five PH groups, with emphasis on PAH and CTEPH. Key changes from 2015: lowered hemodynamic definition (mPAP >20 mmHg, PVR >2 WU), introduction of exercise PH definition, four-strata follow-up risk model, simplified treatment algorithm distinguishing patients with vs without cardiopulmonary comorbidities, new CTEPD-without-PH concept, and upgraded role of balloon pulmonary angioplasty plus medical therapy in CTEPH.

Sepsis & septic shock ⭐

sepsis · society: SCCM/ESICM · high-yield

The 2021 Surviving Sepsis Campaign guidelines provide updated international recommendations for management of adults with sepsis and septic shock, covering screening, initial resuscitation, infection control, hemodynamic support, ventilation, adjunctive therapies, and long-term outcomes. Notable updates from 2016 include a strong recommendation against qSOFA as a sole screening tool, favoring balanced crystalloids over normal saline, suggesting peripheral vasopressor initiation, prolonged beta-lactam infusion, restrictive RRT timing, and new emphasis on post-sepsis recovery, peer support, and follow-up.

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