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Acute respiratory distress syndrome — RCPSC IM MCQ

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HardCritical CareAcute respiratory distress syndromeRCPSC IM

An intubated patient with moderate ARDS has plateau pressure 34 cm H2O on tidal volume 8 mL/kg predicted body weight. What ventilator change is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Use 6 mL/kg ventilation with plateau pressure at most 30 cm H2O

The best answer is “Use 6 mL/kg ventilation with plateau pressure at most 30 cm H2O”. Lung-protective ventilation uses low tidal volume based on predicted body weight and limits plateau pressure, accepting some hypercapnia when necessary. Larger volumes and removal of PEEP can worsen ventilator-induced lung injury.

Reference: Emergency Care BC, emergency-department sepsis guideline: https://emergencycarebc.ca/wp-content/uploads/2022/03/2022-Emergency-Department-Guidelines-FINAL.pdf