Which of the following ventilatory strategies is appropriate when mechanically ventilating a patient with ARDS?

Question

Quizplus · Accepted Answer

The ARDS Network investigated the optimal PEEP-FiO₂ strategy for adults with ARDS. The results of this prospective, randomized, multicenter study indicate that in adult ARDS patients who are ventilated with 6 mL/kg tidal volumes and an end-inspiratory plateau pressure of less than 30 cm H₂O, a "moderately high" or "very high" PEEP strategy produced similar survival rates. It must be noted that this study investigated two relatively aggressive PEEP strategies. Subsequent studies performed outside the United States also showed similar results. In a study involving 30 ICUs and 983 adult patients with ARDS, there was no difference in hospital mortality despite the reduction in the need of rescue therapies in the "high" PEEP group. A recent systematic review on the effect of PEEP in ARDS showed that the subgroup of ARDS patients who may stand to benefit most from a "high" PEEP strategy are those with the worst degree of hypoxemia.

Which of the Following Ventilatory Strategies Is Appropriate When Mechanically