Question

A critically ill patient with COVID-19 is admitted to the ICU and is currently on mechanical ventilation. The \(PaO_2/FiO_2\) ratio is 100, indicating severe ARDS. Which of the following is the most appropriate ventilatory strategy?

• A. High PEEP and low tidal volume
• B. High PEEP and high tidal volume
• C. Low PEEP and low tidal volume
• D. Low PEEP and high tidal volume

Hint:

ARDS ventilation = low tidal volume plus adequate/high PEEP.

Answer 1

The Correct Option is A

Concept: ARDS is managed with lung-protective ventilation. This includes low tidal volume ventilation and adequate or high PEEP to improve oxygenation and prevent alveolar collapse.

Step 1: Identify ARDS severity.
\[ PaO_2/FiO_2 = 100 \] This indicates severe ARDS.

Step 2: Recall lung-protective strategy.
Low tidal volume helps reduce ventilator-induced lung injury.

Step 3: Role of PEEP.
High PEEP helps keep alveoli open and improves oxygenation. Therefore, the best ventilatory strategy is: \[ \text{High PEEP and low tidal volume} \]