positive end-expiratory pressure, and FiO2 are set in accordance with ARDSNet protocols. Settings are adjusted to maintain an oxygen saturation of 88 to
95 percent and a plateau pressure of 30 cm H2O or less to avoid barotrauma. Clinical practice guidelines recommend maintaining an arterial pH of 7.30 to 7.45, although patients in some research trials have tolerated permissive hypercapnia and a pH as low as 7.15.20-22
Evidence has shown that starting with low tidal volumes of 6 mL per kg is superior to starting with traditional tidal volumes of 10 to 15 mL per kg