Critical care: lung-protective ventilation: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Critical care: lung-protective ventilation

Sample item

Which ventilator strategy improves survival in ARDS?

AZero PEEPBTidal volume of 6 mL/kg predicted body weight with plateau pressure below 30 cm H2OCPlateau pressure of 45 cm H2ODTidal volume of 12 mL/kg

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Tidal volume of 6 mL/kg predicted body weight with plateau pressure below 30 cm H2O

The ARDSNet trial showed lower mortality with low tidal volumes of 6 mL/kg than with 12 mL/kg, because of reduced volutrauma. Permissive hypercapnia is accepted and PEEP prevents atelectrauma.

Option by option

A. Zero PEEP
PEEP improves oxygenation.
B. Tidal volume of 6 mL/kg predicted body weight with plateau pressure below 30 cm H2O (correct)
Correct. Low tidal volume reduces mortality.
C. Plateau pressure of 45 cm H2O
A plateau pressure of 45 cm H2O causes barotrauma.
D. Tidal volume of 12 mL/kg
12 mL/kg increased mortality.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Tidal volume of 6 mL/kg predicted body weight with plateau pressure below 30 cm H2O. The ARDSNet trial showed lower mortality with low tidal volumes of 6 mL/kg than with 12 mL/kg, because of reduced volutrauma.

Why is "Zero PEEP" not the answer?

PEEP improves oxygenation.

Why is "Plateau pressure of 45 cm H2O" not the answer?

A plateau pressure of 45 cm H2O causes barotrauma.

Why is "Tidal volume of 12 mL/kg" not the answer?

12 mL/kg increased mortality.

What concept does this question test?

It tests Critical care: lung-protective ventilation in Anaesthesia. Permissive hypercapnia is accepted and PEEP prevents atelectrauma.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Critical care: lung-protective ventilation?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.