In managing a patient with ARDS, what therapeutic strategy is generally utilized?

Mechanical ventilation is the therapeutic strategy generally utilized in managing a patient with Acute Respiratory Distress Syndrome (ARDS) because the primary issue in ARDS is impaired gas exchange due to the decreased lung compliance and increased shunting of blood in the lungs. This results in hypoxemia, which requires intervention to maintain adequate oxygenation and ventilation.

In the context of ARDS, mechanical ventilation allows for controlled delivery of oxygen and the removal of carbon dioxide, helping to support respiratory function while allowing the lungs to rest and recover. The goal of mechanical ventilation in ARDS is often to use a lung-protective strategy that involves using lower tidal volumes to minimize further lung injury and manage plateau pressures.

Other interventions like high-dose steroids may be considered in certain circumstances, particularly in specific subtypes of ARDS or inflammatory contexts, but they are not a first-line treatment and do not directly address the acute gas exchange issues. Antibiotic therapy is essential when there is an underlying infection contributing to ARDS but does not manage the syndrome itself. Bronchodilator therapy might be used to relieve bronchospasm in conditions like asthma or COPD but is not a standard treatment for ARDS, as the primary challenge is not bronchospasm but rather interstitial and alveolar edema.