The ARDSnet recommendations include:
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Targeting tidal volume of 6 ml/kg of predicted body weight
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Oxygenation goal: PaO2 8-10 kPa or SpO2 88-95%
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Plateau pressure goal: ≤ 30 cm H2O
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Permissive hypercapnia, allowing PaCO2 to rise in order to achieve lung protective ventilation (a pH of >7.20 is accepted)
Following adjustment and titration of the ventilator settings the patient remains critically hypoxemic with a PaO2 8.3kPa on FiO2 1.0. He is fully sedated and an infusion of neuromuscular blockade is commenced which has minimal effect. A decision is made to prone the patient.
