Why is it necessary to consider the lung protective strategy in patients with ARDS?

In patients with Acute Respiratory Distress Syndrome (ARDS), it is crucial to consider a lung protective strategy primarily to minimize ventilator-induced lung injury (VILI). ARDS is characterized by inflammation and damage to the lung tissue, which can be exacerbated by mechanical ventilation techniques that deliver high tidal volumes and high pressures. These aggressive ventilation strategies can cause barotrauma, volutrauma, and further inflammation, contributing to worsening lung conditions.

A lung protective strategy typically involves using lower tidal volumes (often around 6 ml/kg of predicted body weight) and maintaining plateau pressures below a certain threshold (usually 30 cm H2O). This approach reduces the risk of overdistending healthy alveoli, thereby preserving lung function and maximizing gas exchange without causing additional harm. Additionally, minimizing the risk of VILI can lead to better outcomes in terms of recovery and survival in ARDS patients.

Other options fail to align with the goals of lung protective ventilation. Increasing airway resistance during ventilation is not a goal of treatment and can complicate patient care. High tidal volumes, while they might seem beneficial for oxygenation, actually pose significant risks and are contrary to lung protective strategies. Lastly, the use of sedatives is often a separate concern that can be managed independently