Ventilation ICU

Question 1

What is the tidal volume target for ARDS patients on a ventilator?

Answer 1

4–6 mL/kg of ideal body weight

Question 2

Why use low tidal volumes in ARDS?

Answer 2

To prevent barotrauma and volutrauma from alveolar overdistension

Question 3

What plateau pressure should be maintained in ARDS?

Answer 3

≤ 30 cm H₂O

Question 4

What is the initial ventilator mode for ARDS?

Answer 4

Volume Assist-Control (AC-VC)

Question 5

What is the minimum acceptable pH in permissive hypercapnia for ARDS?

Answer 5

7.15

Question 6

If plateau pressure is >30 cm H₂O, what should be done?

Answer 6

Reduce tidal volume by 1 mL/kg (down to minimum of 4 mL/kg)

Question 7

What FiO₂ should you aim for once oxygenation improves in ARDS?

Answer 7

Titrate FiO₂ to < 60% if possible while maintaining SpO₂ > 88%

Question 8

What PEEP should be used in ARDS?

Answer 8

Use the PEEP/FiO₂ ARDSnet table

Question 9

When should prone positioning be considered in ARDS?

Answer 9

When PaO₂/FiO₂ < 150 despite optimized vent settings

Question 10

When should neuromuscular blockade be used in ARDS?

Answer 10

If patient is ventilator asynchronous or severely hypoxic despite max support

Question 11

What PaO₂/FiO₂ ratio defines severe ARDS?

Answer 11

< 100 mmHg

Question 12

What are the oxygenation goals for ARDS?

Answer 12

PaO₂ 55–80 mmHg or SpO₂ 88–95%

Question 13

Why do we tolerate high PaCO₂ in ARDS (‘permissive hypercapnia’)?

Answer 13

To avoid lung injury from high tidal volumes