What should be avoided in a patient with ARDS during oxygen treatment?

In acute respiratory distress syndrome (ARDS), oxygen supplementation is indeed vital for managing hypoxemia; however, caution is essential regarding the potential hazards of excessive oxygen. In patients with ARDS, high concentrations of oxygen can lead to oxidative stress and may cause further lung injury, exacerbating the existing condition. This is particularly relevant as ARDS is characterized by severe inflammation and injury to the alveoli, which can already be compromised.

Although supplemental oxygen is necessary to improve oxygen saturation and ensure adequate tissue perfusion, the goal is to use the lowest effective concentration to maintain adequate oxygenation without increasing the risk of lung damage. The use of high levels of oxygen should be closely monitored, sometimes leading to strategies like conservative oxygen therapy or implementing protocols to minimize exposure.

In this context, while other interventions like endotracheal intubation, invasive ventilation, and mechanical restraint might be necessary in more severe cases of ARDS, the careful management of oxygen supplementation focuses on avoiding the negative consequences of hyperoxia, highlighting the delicate balance required in treating this complex condition.