What is the best method for monitoring the pulmonary compliance of a patient with ARDS on mechanical ventilation?

Monitoring pulmonary compliance in a patient with Acute Respiratory Distress Syndrome (ARDS) on mechanical ventilation is crucial for assessing lung function and optimizing ventilation strategies. The best method for this purpose is through the measurement of serial plateau pressures.

Plateau pressure is measured during an inspiratory pause, which reflects the pressure in the lungs when no airflow is occurring. This value is essential for determining the elastic recoil of the lungs. By comparing plateau pressures over time, clinicians can assess changes in lung compliance. Increased plateau pressures may indicate reduced lung compliance, often associated with worsening ARDS, while decreased pressures might suggest improved compliance or recovery.

Monitoring serial plateau pressures provides direct insight into the mechanical properties of the lungs and helps in making necessary adjustments to the ventilator settings, thereby optimizing oxygenation and ventilation while minimizing further lung injury.

The other choices do not specifically evaluate pulmonary compliance as effectively as plateau pressure measurements do. C(a-v)O2 values and PAO2 values provide insights into oxygenation status but do not directly assess lung compliance. Peak pressures reflect the highest pressure during inspiration but do not isolate the contributions of airway resistance and lung compliance as plateau pressures do. Thus, serial plateau pressures offer the most relevant and focused assessment of pulmonary compliance in patients with ARDS on