American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended tidal volume for ARDS?

1. 8 mL/kg of ideal body weight

2. 6 mL/kg of ideal body weight

3. 4 mL/kg of ideal body weight

4. 10 mL/kg of ideal body weight

The correct answer is: 6 mL/kg of ideal body weight

The recommended tidal volume for patients with Acute Respiratory Distress Syndrome (ARDS) is typically set at 6 mL/kg of ideal body weight. This approach is based on evidence from clinical studies that demonstrate this lower tidal volume ventilation strategy can significantly reduce mortality in patients with ARDS compared to higher tidal volume approaches. The rationale is that lower tidal volumes minimize ventilator-induced lung injury by reducing overdistension of alveoli and limiting the risk of barotrauma and volutrauma. This strategy aligns with the ARDSnet guidelines, which emphasize protective lung ventilation to improve outcomes. The ventilation strategy aims to optimize gas exchange while minimizing potential lung injury, which is critical given the pathophysiology of ARDS, characterized by widespread inflammation and impaired gas exchange.