A 46-year-old man with ARDS is being ventilated. The team applies a PEEP of 20 cmH2O. After 30 minutes, they note the PaO2 has worsened (from 9.5 to 7...

Question

A 46-year-old man with ARDS is being ventilated. The team applies a PEEP of 20 cmH2O. After 30 minutes, they note the PaO2 has worsened (from 9.5 to 7.8 kPa) and compliance has decreased. What is the most likely explanation?

Accepted Answer

The PEEP is causing overdistension of compliant lung regions, increasing dead space and worsening V/Q mismatch, without recruiting additional collapsed lung

Answer

The PEEP is too low

Answer

The FiO2 is too high

Answer

Pneumothorax from barotrauma

Answer

Endotracheal tube displacement

uk-fficm MCQ (SBA): ARDS - PEEP Overdistension

A 46-year-old man with ARDS is being ventilated. The team applies a PEEP of 20 cmH2O. After 30 minutes, they note the PaO2 has worsened (from 9.5 to 7.8 kPa) and compliance has decreased. What is the most likely explanation?