Is Pulmonary Vascular Resistance in Acute Respiratory Distress Syndrome the Judge Defining Recruitment versus Overdistention with Positive End-Expiratory Pressure?

The article discusses the challenges faced by clinicians when determining the optimal ventilator settings for patients with acute respiratory distress syndrome (ARDS). The article explains that ARDS causes both lung stiffness and increased dead space, leading to difficulties in maintaining lung volume and oxygenation. The authors propose the use of positive end-expiratory pressure (PEEP) to recruit collapsed alveoli and minimize overdistention, but note that the effectiveness of PEEP varies among patients. The study suggests that personalized PEEP settings based on an assessment of recruitability may be beneficial in managing ARDS. However, the article acknowledges that further research is needed to determine the optimal PEEP and its impact on lung-protective ventilation and outcomes. [Extracted from the article]