What is the rationale behind using a low tidal volume strategy in ARDS management?

A low tidal volume strategy in the management of Acute Respiratory Distress Syndrome (ARDS) is primarily aimed at reducing ventilator-induced lung injury. This approach involves using smaller volumes of air delivered with each breath, which minimizes the risk of over-distention of vulnerable alveoli and helps prevent further lung injury.

In ARDS, the lungs are markedly inflamed and stiff, and traditional ventilation strategies using higher tidal volumes can lead to barotrauma or volutrauma, exacerbating existing damage and impairing gas exchange. By adopting a low tidal volume strategy, clinicians can help protect the lung parenchyma, support better lung recruitment, and improve patients' overall oxygenation without creating additional stress on the respiratory system.

This strategy aligns with evidence gathered from studies demonstrating that patients managed with lower tidal volumes experience improved outcomes, including decreased mortality rates.