What should the plateau pressure (Pplat) be maintained below in ARDS management?

In the management of Acute Respiratory Distress Syndrome (ARDS), it's important to maintain the plateau pressure (Pplat) below a certain threshold to minimize ventilator-induced lung injury. The recommended target for Pplat is generally less than 30 cm H2O. This is because elevated plateau pressures can indicate excessive pressure being applied to the alveoli during mechanical ventilation, leading to further lung damage.

Keeping Pplat below 30 cm H2O helps to ensure that the mechanical ventilation strategy is protective, promoting lung-protective ventilation strategies such as low tidal volume ventilation. By adhering to this guideline, clinicians aim to reduce the risk of barotrauma and volutrauma, which can exacerbate the injury to already compromised lung tissue characteristic of ARDS.

Thus, the choice indicating a Pplat threshold of 30 cm H2O aligns with current recommendations in the management of ARDS, supporting better outcomes for patients by minimizing lung stress and injury while ensuring adequate gas exchange.