What is the recommended maximum plateau pressure to minimize risk?

• A. <20 cmH2O
• B. <30 cmH2O
• C. <40 cmH2O
• D. <50 cmH2O

Answer: (B)

Plateau pressure measures the pressure in the tiny airways and alveoli when airflow is momentarily stopped at the end of inspiration. It reflects how much the lung tissue is being stretched by the breath, independent of airway resistance. Keeping this pressure at a low level reduces overdistension of the alveoli, which lowers the risk of ventilator‑induced lung injury and barotrauma. The recommended maximum plateau pressure to minimize risk is about thirty centimeters of water. If the reading approaches that limit, reduce the tidal volume (for example, to around six milliliters per kilogram of predicted body weight) and/or adjust PEEP to improve lung compliance, rechecking with an inspiratory hold to ensure you’re measuring alveolar, not peak, pressure. The main idea is to prevent excessive lung stretch, since higher plateau pressures are associated with greater injury risk.