Question
A patient with COVID-19 pneumonia presents with severe respiratory distress. Arterial blood gas analysis shows a PaO₂/FiO₂ ratio of less than 100 mmHg. What is the most appropriate ventilatory strategy?
| A. |
Low PEEP, high tidal volume
|
| B. |
High PEEP, low tidal volume
|
| C. |
Low tidal volume, low PEEP
|
| D. |
High tidal volume, high PEEP
|
Show Answer
|
Correct Answer » B
Explanation
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|
A PaO₂/FiO₂ ratio less than 100 mmHg indicates severe Acute Respiratory Distress Syndrome (ARDS) according to the Berlin definition.
COVID-19 pneumonia can progress to ARDS, characterized by:
Management requires lung-protective ventilation.
The recommended ventilatory strategy in ARDS is:
Low tidal volume ventilation (4–6 mL/kg predicted body weight)
This reduces volutrauma and barotrauma.
High PEEP
This prevents alveolar collapse at end-expiration, improves oxygenation, and reduces shunt.
This lung-protective strategy:
Therefore, the correct answer is high PEEP with low tidal volume.
