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Acute respiratory distress syndrome from pancreatitis — SCE Acute Medicine MCQ

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HardCritical care medicineAcute respiratory distress syndrome from pancreatitisSCE Acute Medicine

A 56-year-old man with pancreatitis develops severe hypoxaemia. On volume-controlled ventilation, PaO2/FiO2 ratio is 12 kPa with bilateral infiltrates and no evidence of left atrial hypertension. Plateau pressure is 34 cmH2O on tidal volume 8 mL/kg predicted body weight. What ventilator strategy is most appropriate?

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Correct answer: B — Reduce tidal volume to lung-protective ventilation and limit plateau pressure

ARDS management uses lung-protective ventilation with lower tidal volume based on predicted body weight and plateau pressure limitation. Larger tidal volumes worsen ventilator-induced lung injury. PEEP, proning in severe ARDS and treating the underlying cause are considered within critical care management.

Reference: Faculty of Intensive Care Medicine and ARDS guidance; ARDSNet principles