Which of the following mechanical ventilation strategies were used in the Acute Respiratory Distress Syndrome Network (ARDSnet) study? I. All patients received volume-control ventilation. II. Patients were randomized to receive either pressure- or volume-control ventilation. III. Patients were randomized to receive a VT of either 6 ml/kg or 12 ml/kg. IV. A plateau pressure of 30 cm H2O or less

was targeted for patient receiving low VTs.

A. I, III only
B. III, IV only
C. I, II, IV only
D. I, III, IV only

?ANS: D
A. Incorrect response: All patients received volume-control ventilation, and patients were randomized to receive a VT of either 6 ml/kg or 12 ml/kg. However, those receiving low tidal volumes were ventilated at a plateau pressure of 30 cm H2O or less.
B. Incorrect response: See explanation D.
C. Incorrect response: Pressure-controlled ventilation was not included in this study.
D. Correct response: All patients with acute lung injury (ALI) were randomized to receive volume-controlled ventilation at either conventional tidal volume of 12 ml/kg or lower tidal volumes of 6 ml/kg of ideal body weight. In lower tidal volume group, the target plateau pressure was 30 cm H2O or less, and if the plateau pressure was greater than 30 cm H2O, VT was decreased to a minimum of 4 ml/kg.