What does the "lung protective strategy" entail in mechanical ventilation?

The lung protective strategy in mechanical ventilation emphasizes the use of lower tidal volumes and moderate levels of positive end-expiratory pressure (PEEP) to reduce the risk of ventilator-induced lung injury. This approach is based on the understanding that high tidal volumes can cause over-distension of alveoli, leading to barotrauma and exacerbating lung injury, especially in patients with acute respiratory distress syndrome (ARDS).

By targeting a lower tidal volume—typically around 6 ml/kg of predicted body weight—this strategy aims to minimize volutrauma while ensuring adequate gas exchange. The use of moderate PEEP helps to keep alveoli open at the end of expiration, thereby improving oxygenation and reducing shunting without significantly raising airway pressures. This balanced approach helps to protect lung tissue while promoting effective ventilation and oxygenation.

In contrast, the other options do not align with the principles of a lung protective strategy. High tidal volumes would increase the risk of injury, while simply focusing on increasing airway pressures ignores the potential negative effects on lung mechanics. Moreover, utilizing sedatives primarily alters patient respiratory effort but does not directly address the mechanical aspects of ventilation that are crucial for lung protection.