Challenges encountered in employing a low tidal volume ventilation strategy in patients at risk of ARDS

Introduction Ventilator strategies that use tidal volumes (TVs) limited to 6 ml/kg IBW (ideal body weight) have been shown to reduce mortality in patients with ARDS (acute respiratory distress syndrome). [1] It is suggested that using these same low tidal volumes in other critically ill patients may reduce the progression to ARDS. [2,3] An initial audit in the ICU at University Hospital Lewisham demonstrated that patients without ARDS were receiving mandatory ventilation in excess of 8 ml/kg IBW >40% of the time.