How long do you strictly enforce low tidal volume ventilation in ARDS?

I do not believe that there is data specifically looking at during duration of LTVV in ARDS vs shorter durations. However, there are multiple trials that argue that LTVV in ARDS and patients at risk for ARDS improves mortality outcomes with minimal negative side effects. In my practice, I try to adhere to TV between 4-6cc/kg, especially in the early days of a patient in ARDS when lung compliance is especially low, and will liberate to 6-8 cc/kg as the patient is starting to heal.

Vent dyssynchro...

I use low tidal volumes throughout the entire course of ventilation in patients with ARDS as well as those with non-ARDS acute hypoxemic respiratory failure (AHRF). It is important to note that while the target tidal volume in the lung protective ventilation (LPV) group of the ARMA trial was 6 mL/kg PBW, the allowable range was between 4 and 8 mL/kg PBW, not 4 to 6 mL/kg PBW. Thus, I will comfortably increase the volume up to 8 mL/kg PBW as needed in patients with early or late ARDS, and in thos...