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In patients with Acute Respiratory Distress Syndrome (ARDS), the ARDSnet protocol recommends low tidal volume ventilation as a primary strategy for respiratory support. This approach is based on evidence demonstrating that using smaller tidal volumes (generally around 6 mL/kg of predicted body weight) can significantly reduce the risk of ventilator-induced lung injury and improve survival outcomes.

Low tidal volume ventilation helps to minimize over-distension of alveoli, which could otherwise exacerbate lung injury in ARDS patients by causing further barotrauma or volutrauma. The rationale behind this technique is that the reduced tidal volume, combined with higher respiratory rates, can maintain adequate minute ventilation while protecting the lungs.

The ARDSnet study has shown that this approach significantly improves oxygenation and reduces mortality compared to traditional high tidal volume strategies. This evidence has led to the widespread adoption of low tidal volume ventilation in clinical practice for managing ARDS.

Other forms of ventilatory support, such as high-frequency oscillatory ventilation or positive end-expiratory pressure ventilation, can be used in certain scenarios or as adjuncts, but they are not the primary recommendation according to the ARDSnet protocol. Conventional mechanical ventilation, which often utilizes higher tidal volumes, has also been largely replaced by low