Fixed 2 · 26 min · fixed

Belly tight, cabin high

ARDSNet ARMA / ALVEOLI · ATS 2024 · ARDSNet: 6 mL/kg PBW · Pplat ≤30 · ΔP ≤14 · SpO₂ 88–95 · PaCO2 ~35–45

Load card puts the starting breath on the box. Connect starts the clock. End whenever you want.

55-year-old woman, pancreatitis, IAH 22 mmHg, secondary ARDS. Long fixed-wing.

Rest of the scene

Cabin scheduled 8,000 ft. Belly is a second diaphragm.

Handoff

Pplat already 29 on PEEP 12. They want her at the quaternary ICU. Gas expansion will make the belly worse. You need sea-level cabin or a smarter PEEP, not both high.

3 objectives
  1. 1

    Treat cabin as a setting

    Ask for 2,000 ft or raise FiO2 before the climb.

  2. 2

    Lung Pplat ≤30 — the belly is not the lung

    IAH raises measured Pplat. Hold and read ΔP lung. Do not cut a 6 mL/kg breath for chest wall.

  3. 3

    Don't lose the kidney — MAP ≥ 70

    High Paw + IAH = no venous return.

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