Low Tidal Volume Ventilation in Acute Respiratory Distress Syndrome

Abstract This chapter appraises the ARMA trial, which compared low tidal volume ventilation (6 cc/kg predicted body weight) with traditional ventilation (12 cc/kg) in patients with acute respiratory distress syndrome (ARDS). The trial demonstrated that low tidal volume ventilation reduced 180-day mortality, increased ventilator-free days, and improved the likelihood of breathing independently by day 28. The chapter details how lower tidal volumes result in lower plateau pressures without increasing the risk of barotrauma. These findings challenged previous ventilation strategies and established low tidal volume as the standard of care for ARDS management. Finally, the chapter discusses the wider implications of these results in refining ventilator settings and improving ARDS patient outcomes.