Ventilatory Management for Acute Respiratory Distress Syndrome (ARDS)

presented by John Davies, MA, RRT, FAARC, FCCP

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Financial: John Davies is a medical consultant for Medline. He also receives compensation from MedBridge for the production of this course.

Nonfinancial: John Davies has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Video Runtime: 51 Minutes; Learning Assessment: 23 Minutes

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, MA, RRT, FAARC, FCCP

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. Neil…

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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.

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