What should you do in ARDS if plateau pressure is too high?

In the context of managing Acute Respiratory Distress Syndrome (ARDS), if plateau pressure is too high, the most appropriate action is to decrease tidal volume and increase the respiratory rate.

Plateau pressure reflects the pressure in the lungs during an inspiratory pause and is a critical parameter to monitor, as it can indicate over-distension of the alveoli. Keeping plateau pressure within safe limits is essential to prevent ventilator-induced lung injury.

By reducing the tidal volume, you decrease the volume of air entering the lungs with each breath, thus lowering the pressure exerted on the alveoli. Simultaneously, increasing the respiratory rate compensates for the reduction in tidal volume, helping to maintain adequate ventilation and oxygenation. This approach follows the lung-protective ventilation strategy commonly recommended in ARDS management, which aims to minimize further lung injury while providing adequate gas exchange.

This understanding reinforces the importance of titrating ventilation settings carefully in ARDS to ensure patient safety and optimize respiratory function.