摘要目前急性呼吸窘迫综合征（ARDS）仍然是威胁重症监护病房（ICU）患者生命健康的重要疾病之一。2023年《欧洲危重病医学会ARDS指南：定义、分型和呼吸支持策略》 （以下简称"2023指南"）对2017年《美国胸科学会/欧洲危重病医学会/危重病医学会临床实践指南：成人ARDS患者的机械通气》（以下简称"2017指南"）进行了更新，包括定义、分型、呼吸支持策略3个主题的7个方面内容〔即经鼻高流量氧疗（HFNO）、无创通气（NIV）、神经肌肉阻滞剂（NMBA）、体外生命支持（ECLS）、呼气末正压（PEEP）与肺复张（RM）、潮气量（VT）、俯卧位〕。2023指南回顾和总结了2017指南发表以来的各类文献，涵盖了ARDS和急性低氧血症性呼吸衰竭，也包括了由新型冠状病毒感染引起的ARDS。基于最新的循证医学证据，2023指南为临床医生提供了对于成人ARDS非药物呼吸支持策略的新理念与新方法。本文对于2023指南中ARDS的新理念和新方法以及新的推荐分级和新的证据等级进行了解读。

abstractsAcute respiratory distress syndrome (ARDS) continues to be one of the most life-threatening conditions for patients in the intensive care unit (ICU). The 2023 European Society of Intensive Care Medicine guidelines on ARDS: definition, phenotyping and respiratory support strategies ( 2023 Guideline) update the 2017 An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine clinical practice guideline: mechanical ventilation in adult patients with ARDS ( 2017 Guideline), including 7 aspects of 3 topics of definitions, phenotyping, and respiratory support strategies [including highflow nasal cannula oxygen (HFNO), non-invasive ventilation (NIV), neuromuscular blocking agents (NMBA), extracorporeal life support (ECLS), positive end-expiratory pressure (PEEP) with recruitment maneuvers (RM), tidal volume (VT), and prone positioning]. 2023 Guideline review and summarize the literature since the publication of the 2017 Guideline, covering ARDS and acute hypoxemic respiratory failure, as well as ARDS caused by novel coronavirus infection. Based on the most recent medical evidence, the 2023 Guideline provide clinicians with new ideas and approaches for nonpharmacologic respiratory support strategies for adults with ARDS. This article provides interpretation of the new concepts, the new approaches, the new recommended grading and new levels of evidence for ARDS in the 2023 Guideline.