A 45-year-old woman with severe ARDS (PaO2/FiO2 ratio 80 mmHg) has been ventilated with TV 6 mL/kg IBW, PEEP 14 cmH2O, FiO2 1.0, and RR 30/min for 12 ...

Question

A 45-year-old woman with severe ARDS (PaO2/FiO2 ratio 80 mmHg) has been ventilated with TV 6 mL/kg IBW, PEEP 14 cmH2O, FiO2 1.0, and RR 30/min for 12 hours. Plateau pressure is 28 cmH2O. Despite optimisation, her oxygenation remains critically poor. What is the most appropriate next intervention?

Accepted Answer

Initiate prone positioning for at least 16 hours per session

Answer

Administer inhaled nitric oxide at 20 ppm

Answer

Commence high-frequency oscillatory ventilation

Answer

Increase PEEP to 20 cmH2O

Answer

Administer intravenous methylprednisolone 2 mg/kg

uk-fficm MCQ (SBA): ARDS

A 45-year-old woman with severe ARDS (PaO2/FiO2 ratio 80 mmHg) has been ventilated with TV 6 mL/kg IBW, PEEP 14 cmH2O, FiO2 1.0, and RR 30/min for 12 hours. Plateau pressure is 28 cmH2O. Despite optimisation, her oxygenation remains critically poor. What is the most appropriate next intervention?