Ventilatory Management for Acute Respiratory Distress Syndrome (ARDS)
Presented by John Davies
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Managing a patient with acute respiratory distress syndrome (ARDS) can be challenging. The key is to identify and treat the underlying cause, if possible. Additionally, the implementation of lung-protective ventilation is key in preventing further pulmonary injury. This course will equip respiratory therapists with the tools to examine how ARDS changes a patient’s pulmonary mechanics and subsequently identify and apply conventional and rescue ventilatory strategies for the successful management of ARDS.
Meet your instructor
John Davies
John Davies is a clinical research coordinator in the field of adult critical care at Duke University Medical Center in Durham, North Carolina. He has worked at Duke for 30 years. John is one of the co-chairs of the Mechanical Ventilation Simulation Committee for the American College of Chest Physicians (ACCP) along with Dr.…
Chapters & learning objectives
1. Pathophysiology of ARDS and Initial Management
This chapter will review the pathophysiology of ARDS, from the initial injury to the devastating effects it can have on the lungs. Strategies for the initial management of ARDS, including high-flow nasal cannula and noninvasive ventilation, will be discussed.
2. Ventilator-Induced Lung Injury (VILI)
Inappropriate mechanical ventilation has the potential to lead to VILI in three main areas. These include high plateau pressures, large tidal volumes, and an unbalanced combination of PEEP and FiO2.
3. Conventional Ventilatory Management of ARDS
Conventional management of mechanical ventilation focuses on being bot safe (avoiding VILI) and effective (oxygenation and CO2 clearance). It includes strategies to keep the plateau pressure below 30 cmH2O, minimizing tidal volume and optimizing PEEP/FiO2.
4. When Conventional Ventilation Strategies Fail
There are instances where conventional ventilation fails and other measures are considered. Strategies such as prone ventilation, APRV, and ECMO may have a place in certain clinical situations.
