A 60-year-old male with severe ARDS is intubated and mechanically ventilated. Despite increasing positive end-expiratory pressure (PEEP) to 15 cmH2O and optimizing tidal volumes, his oxygen saturation remains 88% on 100% FiO2. His plateau pressure is 32 cmH2O. He is already proned. What is the most appropriate next step to improve oxygenation?
✓ Correct Answer: Option C
For severe ARDS refractory to conventional ventilation strategies (optimized PEEP, low tidal volume, proning), neuromuscular blockade can improve oxygenation by reducing oxygen consumption, improving ventilator synchrony, and minimizing patient-ventilator asynchrony and lung injury.