Which statement describes the open lung approach used in ARDS management?

• A. Open lung approach
• B. Inverse ratio ventilation
• C. High frequency ventilation
• D. No PEEP

Answer: (A)

The open lung approach centers on preventing repetitive opening and closing of collapsed alveoli by actively recruiting them and then keeping them open with adequate PEEP. In ARDS, many air sacs collapse at the end of expiration; using a recruitment maneuver helps reopen them, and maintaining sufficient PEEP afterward prevents derecruitment so those areas stay aerated during the next breath. This approach is usually paired with lung‑protective ventilation—low tidal volumes, limit on plateau pressure, and careful control of driving pressure—so the open, recruited lung isn’t harmed by overdistension. In practice, you recruit to open alveoli and then set PEEP high enough to maintain that recruitment while avoiding excessive pressures.

The other options don’t describe this concept. Inverse ratio ventilation changes the timing of inspiration and expiration but doesn’t define the open‑lung strategy. High frequency ventilation uses very small breaths at high rates and is a distinct modality, not the open lung concept. No PEEP would promote collapse, which is the opposite of keeping the lung open.