The inflammatory response to sepsis can cause lung injury and the development of ARDS. In a landmark multicenterrandomized trial of lung-injured patients, those who underwent mechanical ventilation with lung-protective ventilation (low tidal volumes of 6 mL/kg of predicted body weight and low plateau pressures 6 30 cm H2O) had a 9% absolute reduction in mortality.68 As such, this is the preferred ventilation strategy. Following intubation, fractions of inspired oxygen(FiO2) should be reduced as soon as possible to prevent oxygen toxicity. Maintaining low levels of positive end-expiratory pressure (PEEP) can prevent extensive alveolar collapse at end-expiration.Additionally, the head of the bed should
be elevated 30–45 as it has prospectively been shown to reduce the rate of ventilator-associated pneumonia.