In adult ARDS management, which ventilation strategy is recommended?

In adult ARDS management, which ventilation strategy is recommended?

• A. High tidal volumes
• B. Low tidal volumes with PEEP
• C. No PEEP
• D. Spontaneous breathing without ventilation

Answer: (B)

Protective lung ventilation is the cornerstone of adult ARDS management. Using small tidal volumes (about 4–6 mL per kilogram of predicted body weight) limits alveolar overdistension, reducing volutrauma and the inflammatory response that accelerates lung injury. Adding PEEP helps keep the collapsed alveoli open at end expiration, improving oxygenation and preventing repeated opening and closing that causes shear injury. Together, low tidal volumes with appropriate PEEP provide better outcomes by maintaining gas exchange while minimizing ventilator-induced lung injury. High tidal volumes damage the lung, no PEEP allows derecruitment and hypoxemia, and spontaneous breathing without ventilation doesn’t provide the necessary support for severe ARDS.

Protective lung ventilation is the cornerstone of adult ARDS management. Using small tidal volumes (about 4–6 mL per kilogram of predicted body weight) limits alveolar overdistension, reducing volutrauma and the inflammatory response that accelerates lung injury. Adding PEEP helps keep the collapsed alveoli open at end expiration, improving oxygenation and preventing repeated opening and closing that causes shear injury. Together, low tidal volumes with appropriate PEEP provide better outcomes by maintaining gas exchange while minimizing ventilator-induced lung injury. High tidal volumes damage the lung, no PEEP allows derecruitment and hypoxemia, and spontaneous breathing without ventilation doesn’t provide the necessary support for severe ARDS.