A patient with severe Acute Respiratory Distress Syndrome (ARDS) is on mechanical ventilation. Which of the following ventilator strategies is most consistent with lung-protective ventilation in ARDS?

Explanation

Lung-protective ventilation is a cornerstone of ARDS management, aiming to minimize ventilator-induced lung injury (VILI). The key components include: 1. Low tidal volumes: 4-6 mL/kg of predicted (ideal) body weight to reduce volutrauma. 2. Plateau pressure limitation: Maintaining plateau pressure (pressure measured during an end-inspiratory hold) below 30 cmH2O to prevent barotrauma. 3. Optimal PEEP: Titrating PEEP to prevent alveolar collapse and improve oxygenation, often using higher PEEP levels. Option B aligns perfectly with these principles. Options A and C use higher tidal volumes which are detrimental in ARDS. Option D focuses on peak inspiratory pressure, which is less indicative of alveolar distension than plateau pressure, and the tidal volume range is still higher than recommended for severe ARDS.