For ARDS, which do we pick as the "next BEST step": Low tidal volume or PEEP?

[Knicks]

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If low tidal volume and PEEP are both separate answer choices, what's the next BEST step in ARDS?

 

[Nabin]

I'd go for PEEP. Provided the stem has Fio2 within an acceptable range, lowering tidal volume would be inappropriate because the patient is mostly likely has hypoxemia, and we don't want alveoli collapsing and collecting secretions to further aggravate the A-a gradient. And usually, normal weight-adjusted tidal volumes should be fine in ARDS patients. I think the answer will depend on the scenario being given, whether the patient looks fine with good saturation and you're more concerned about the barotrauma risk than oxygenation.

 

[DrPettans]

Are "PEEP" (positive end-expiratory pressure) and "mechanical ventilation with low tidal volumes" different things?

 

[Instatewaiter]

Are "PEEP" (positive end-expiratory pressure) and "mechanical ventilation with low tidal volumes" different things?

Is this a joke or are you really not an attending?

 

[Instatewaiter]

If low tidal volume and PEEP are both separate answer choices, what's the next BEST step in ARDS?

need more information. Has the patient already been on vent settings? If so, what were those settings?

Post the rest of the question and I will answer it.