Why is lower tidal volume ventilation used in ARDS?

Lower tidal volume ventilation is utilized in ARDS primarily to minimize ventilator-induced lung injury. In patients with Acute Respiratory Distress Syndrome (ARDS), the lungs are often inflamed and less compliant, which makes them more susceptible to damage from mechanical ventilation. High tidal volumes can over-distend alveoli, leading to barotrauma and exacerbating lung injury.

By using lower tidal volumes, typically around 6 ml/kg of predicted body weight, the strategy aims to reduce the risk of over-distension and preserve the functionality of the remaining healthy lung tissue. This approach not only helps to prevent further lung injury but also allows for more effective manipulation of airway pressures and improves overall oxygenation without compromising ventilation excessively.

This method has been shown to improve outcomes for patients with ARDS, making it a critical component of protective lung strategies in mechanical ventilation.