What is the significance of monitoring plateau pressure in ARDS?

Monitoring plateau pressure in patients with Acute Respiratory Distress Syndrome (ARDS) is particularly significant because it helps indicate the risk of ventilator-induced lung injury. Plateau pressure is measured during a respiratory pause at the end of inspiration, providing a reliable assessment of the pressures experienced by the lungs during mechanical ventilation.

In ARDS, the lungs are often stiff or non-compliant, which can lead to higher plateau pressures. When plateau pressure exceeds certain thresholds (generally considered to be 30 cm H2O), it indicates increased distention of the alveoli and may result in further lung injury, potentially exacerbating the patient’s condition. By keeping plateau pressures low (ideally below 30 cm H2O), clinicians can minimize the risk of barotrauma and volutrauma, both of which can damage the lung tissue and worsen ARDS.

Monitoring this parameter is therefore critical for guiding mechanical ventilation strategies and ensuring protective lung ventilation approaches are implemented, ultimately improving patient outcomes.