ICU SAQs · Mechanical ventilation
Lung-protective ventilation in ARDS
A core Second-Part question on lung-protective ventilation — the tidal-volume, plateau-pressure and driving-pressure targets, the 'baby lung' concept, and the landmark trials (ARDSNet 2000; Amato 2015 driving pressure) that established them.
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Prompt
A 65-year-old man with severe community-acquired pneumonia is intubated for type 1 respiratory failure. His PaO2/FiO2 ratio is 90 mmHg with bilateral infiltrates. Describe your lung-protective ventilation strategy and the evidence that governs it.
Question
A 65-year-old man with severe community-acquired pneumonia is intubated for type 1 respiratory failure. His PaO2/FiO2 ratio is 90 mmHg with bilateral infiltrates. Describe your lung-protective ventilation strategy and the evidence that governs it.
[1]References5ShowHide
- [1]Brower RG, Matthay MA, Morris A, et al. Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress Syndrome. New England Journal of Medicine, 2000.PMID 10793162
- [2]Amato MBP, et al. Driving Pressure and Survival in the Acute Respiratory Distress Syndrome. New England Journal of Medicine, 2015.PMID 25693014
- [3]Gattinoni L, et al. Regional Physiology of ARDS. Critical Care, 2017.PMID 29297365
- [4]Bersten AD, Soni N (eds). Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [5]Marino PL. The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.