Maintenance “DOSE”
Dry Lungs - “Dry lungs -Happy lungs”
- Maintain negative fluid balance to reduce pulmonary edema
Open but not Over-distended
- Kept Open by optimizing PEEP
- Not overdistended by LTVV
- LTVV - Low tidal volume ventilation ( Permissive hypercapnic respiratory acidosis)
- Limit alveolar distending volume (VT 6 mL/kg) & pressure (Pplat ≤30 cm H2O)
Sepsis\ Source Control
- Steroid for Moderate to severe ARDS
- Assess for fluid-responsiveness prior to blind volume loading (eg, via passive leg raise to simulate a fluid bolus) in Septic Shock
Extubation timely to minimize sedation.
That’s all!
Thank you!
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