Selected article for: "current evidence and tidal volume"
Author: Terzi, Nicolas; Guérin, Claude
Title: Optimizing Mechanical Ventilation in Refractory ARDS
  • Cord-id: ab0p5r5e
  • Document date: 2019_12_31
    • ID: ab0p5r5e
    Snippet: Mechanical ventilation in patients with refractory acute respiratory distress syndrome (ARDS) must provide lung protection. This is achieved by limiting tidal volume (VT) and plateau pressure (Pplat). With the current evidence available VT should be initially set around 6mL per kg predicted body weight and PPlat maintained below 30cmH2O and monitored. Positive end-expiratory pressure (PEEP), which also contributes to lung protection, should be set >12cmH2O, provided oxygenation gets improved, wi
    Document: Mechanical ventilation in patients with refractory acute respiratory distress syndrome (ARDS) must provide lung protection. This is achieved by limiting tidal volume (VT) and plateau pressure (Pplat). With the current evidence available VT should be initially set around 6mL per kg predicted body weight and PPlat maintained below 30cmH2O and monitored. Positive end-expiratory pressure (PEEP), which also contributes to lung protection, should be set >12cmH2O, provided oxygenation gets improved, with same Pplat target. Recruitment maneuvers should be used with caution avoiding higher PEEP. Neuromuscular blockade should be started and prone position performed for sessions longer than 16h. High frequency oscillation ventilation should be used in expert centers only if previous management failed to improve oxygenation.

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