🫁 ARDS Lung-Protective Ventilation (ARDSnet)
Lung-protective ventilation settings for ARDS, centered on low tidal volume and plateau-pressure/driving-pressure limits.
Tidal volume is set by predicted (not actual) body weight — the lung size tracks height and sex, not weight (original synthesis · not guideline verbatim).
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When to use
Use in mechanically ventilated ARDS patients to set tidal volume by predicted body weight and to check whether plateau pressure, driving pressure, and oxygenation targets are met.
How it works
Low tidal volume 4–8 mL/kg predicted body weight (start ~6); plateau pressure ≤ 30 cmH₂O; driving pressure (Pplat − PEEP) ideally < 15 cmH₂O; permissive hypercapnia tolerated; titrate PEEP/FiO₂ to oxygenation; prone positioning for severe ARDS (P/F < 150).
Key points
- Tidal volume is set by predicted (not actual) body weight — the lung size tracks height and sex, not weight (original synthesis · not guideline verbatim).
- Driving pressure has emerged as a strong mortality-associated variable; keeping it low can matter even when tidal volume is already limited.
- Severe ARDS benefits from prone positioning ≥ 16 h/day and consideration of neuromuscular blockade and ECMO referral.
References
- ARDSNet (ARMA) low tidal volume trial. N Engl J Med 2000.
- Amato MBP, et al. Driving pressure and survival in ARDS. N Engl J Med 2015.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Sex | Male |
|---|---|
| Height | 170 cm |
→Tidal volume (6 mL/kg)396 mL
- Predicted body weight (PBW)：66 kg (male, height 170 cm)
- Target tidal volume：6 mL/kg = 396 mL (may start at 8 mL/kg = 528 and reduce by 1 every 2 h to 6; range 4–8)
- Plateau-pressure target：Pplat ≤ 30 cmH₂O; if > 30 reduce TV to 5 mL/kg (330) then 4 (264); if TV < 6 and Pplat < 25, may increase by 1 up to a max of 6
| Sex | Female |
|---|---|
| Height | 170 cm |
→Tidal volume (6 mL/kg)369 mL
- Predicted body weight (PBW)：61.5 kg (female, height 170 cm)
- Target tidal volume：6 mL/kg = 369 mL (may start at 8 mL/kg = 492 and reduce by 1 every 2 h to 6; range 4–8)
- Plateau-pressure target：Pplat ≤ 30 cmH₂O; if > 30 reduce TV to 5 mL/kg (308) then 4 (246); if TV < 6 and Pplat < 25, may increase by 1 up to a max of 6
Frequently asked questions
- What is ARDS Lung-Protective Ventilation (ARDSnet)?
- Lung-protective ventilation settings for ARDS, centered on low tidal volume and plateau-pressure/driving-pressure limits.
- How is ARDS Lung-Protective Ventilation (ARDSnet) calculated? What is the core formula?
- Low tidal volume 4–8 mL/kg predicted body weight (start ~6); plateau pressure ≤ 30 cmH₂O; driving pressure (Pplat − PEEP) ideally < 15 cmH₂O; permissive hypercapnia tolerated; titrate PEEP/FiO₂ to oxygenation; prone positioning for severe ARDS (P/F < 150).
- When is ARDS Lung-Protective Ventilation (ARDSnet) used?
- Use in mechanically ventilated ARDS patients to set tidal volume by predicted body weight and to check whether plateau pressure, driving pressure, and oxygenation targets are met.
- What are the key clinical points for ARDS Lung-Protective Ventilation (ARDSnet)?
- Tidal volume is set by predicted (not actual) body weight — the lung size tracks height and sex, not weight (original synthesis · not guideline verbatim). Driving pressure has emerged as a strong mortality-associated variable; keeping it low can matter even when tidal volume is already limited. Severe ARDS benefits from prone positioning ≥ 16 h/day and consideration of neuromuscular blockade and ECMO referral.
- What are the limits and cautions when using ARDS Lung-Protective Ventilation (ARDSnet)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is ARDS Lung-Protective Ventilation (ARDSnet) calculated in practice? Can you show a worked example?
- Inputs: Sex Male, Height 170 cm → Result: Tidal volume (6 mL/kg) 396 mL（Predicted body weight (PBW): 66 kg (male, height 170 cm), Target tidal volume: 6 mL/kg = 396 mL (may start at 8 mL/kg = 528 and reduce by 1 every 2 h to 6; range 4–8), Plateau-pressure target: Pplat ≤ 30 cmH₂O; if > 30 reduce TV to 5 mL/kg (330) then 4 (264); if TV < 6 and Pplat < 25, may increase by 1 up to a max of 6） Inputs: Sex Female, Height 170 cm → Result: Tidal volume (6 mL/kg) 369 mL（Predicted body weight (PBW): 61.5 kg (female, height 170 cm), Target tidal volume: 6 mL/kg = 369 mL (may start at 8 mL/kg = 492 and reduce by 1 every 2 h to 6; range 4–8), Plateau-pressure target: Pplat ≤ 30 cmH₂O; if > 30 reduce TV to 5 mL/kg (308) then 4 (246); if TV < 6 and Pplat < 25, may increase by 1 up to a max of 6）