Which ventilatory parameters are closely monitored during the management of ARDS?

The focus on tidal volume, PEEP (positive end-expiratory pressure), plateau pressure, and FiO2 (fraction of inspired oxygen) adjustments during the management of ARDS is crucial due to the nature of the disease and the goals of mechanical ventilation in these patients.

In ARDS, there is significant impairment in gas exchange and lung compliance, leading to both atelectasis and hypoxemia. Tidal volume is monitored closely because using lower tidal volumes helps to prevent ventilator-induced lung injury and manage the risk of barotrauma by avoiding excessive airway pressures. PEEP is another critical parameter since it helps to keep alveoli open, improve oxygenation, and recruit collapsed lung units, thus enhancing overall lung mechanics.

Plateau pressure is essential to monitor because it reflects the pressure needed to inflate the lungs and helps assess lung compliance. High plateau pressures can indicate over-distension or poor lung mechanics, both of which can worsen lung injury. Lastly, FiO2 is adjusted based on the patient's oxygenation needs, as the goal is to maintain adequate oxygen saturation while minimizing exposure to high concentrations of oxygen, which can be toxic.

By focusing on these parameters, healthcare providers can optimize respiratory support while protecting the patient's lung tissue during mechanical ventilation in AR