What does the management of Acute Respiratory Distress Syndrome focus on regarding plateau pressures?

The management of Acute Respiratory Distress Syndrome (ARDS) includes a critical focus on the maintenance of plateau pressures in order to minimize ventilator-induced lung injury. Keeping plateau pressures below 30 mmHg is recommended as part of the lung-protective ventilation strategy. This goal helps to reduce the risk of barotrauma and further injury to the lung tissue, which is particularly susceptible in ARDS patients.

Maintaining plateau pressures below this level is important because elevated pressures can cause stress on the alveolar-capillary membrane, increasing the likelihood of lung injury and exacerbating the patient's condition. Therefore, adhering to this guideline in ventilation management is essential for improving outcomes in patients with ARDS.

The other suggested levels, such as aiming for a plateau of 20 mmHg or above 35 mmHg, do not align with current best practices in ARDS management, as both could pose significant risks of lung injury. Similarly, the idea of stabilizing pressures at any level does not adhere to the targeted treatment strategies that prioritize lung protection and patient safety.