What is the goal plateau pressure during mechanical ventilation in ARDS as per the ARMA trial?

The goal plateau pressure during mechanical ventilation in patients with Acute Respiratory Distress Syndrome (ARDS), as demonstrated in the ARMA (Acute Respiratory Management in ARDS) trial, is less than 30 cm H2O. This target was established to minimize ventilator-induced lung injury while promoting adequate gas exchange.

Maintaining a plateau pressure below 30 cm H2O helps to limit the overdistension of alveoli and reduces the risk of barotrauma. High pressures can lead to further lung injury, which is particularly critical in ARDS where the lung parenchyma is already compromised. The ARMA trial confirmed that applying a strategy of low tidal volume ventilation, which inherently associates with lower plateau pressures, improves outcomes in ARDS patients.

Understanding this benchmark is essential for managing patients on mechanical ventilation and ensuring optimal lung protection strategies.