Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-Mechanical Ventilation III: Management of Acute Respiratory Failure/ARDS

Mechanical Ventilation III: Management of Acute Respiratory Failure/ARDS

Video Transcription

Video Summary

This lecture covered key concepts critical for understanding and managing Acute Respiratory Distress Syndrome (ARDS). The speaker first explained transpluminary pressure and driving pressure — both essential in mechanical ventilation. Transpluminary pressure is calculated as alveolar pressure minus pleural pressure, important in both spontaneously breathing individuals and those on positive pressure ventilation. Driving pressure, the difference between plateau pressure and PEEP, should ideally be below 14-15 to minimize lung strain.<br /><br />The lecture then discussed ARDS, mainly treating it through low tidal volume ventilation (6 cc/kg ideal body weight) and high PEEP to recruit alveoli and minimize lung injury. The use of proning in cases where P/F ratio remains below 150 despite optimal ventilation strategies shows significant benefit for ARDS management. Other therapies like neuromuscular blockade, inhaled nitric oxide, and ECMO were mentioned, emphasizing ECMO as a bridge therapy. The talk effectively detailed practical guidelines and evidence-based strategies in ARDS management.

Keywords

ARDS

mechanical ventilation

transpluminary pressure

driving pressure

ECMO

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