157: Cracking the ARDS Code: A Deep Dive on ARDS Vent Management Strategies With Melody Bishop RT
From Rapid Response RN by Sarah Lorenzini
February 28, 2026 · 51 min
About this episode
This episode features a deep dive into ARDS ventilator management with respiratory therapist Melody Bishop, focusing on physiology and evidence-based practices.
ARDS is one of the more complex syndromes we manage in critical care. More than just pulmonary edema, we are battling stiff lungs, refractory hypoxemia, rising pressures, and frequently making decisions that can either protect the lung or make things worse. In this episode, I’m joined by respiratory therapist Melody Bishop for a deep dive into ARDS ventilator management through the lens of physiology, evidence, and real bedside practice. We break down what’s actually happening in the lung , why some long-held practices have fallen out of favor, and how nurses and RTs can work together to make more precise, lung-protective decisions. If ARDS has ever felt like guesswork, this episode will help it make sense. Topics discussed in this episode: What ARDS looks like at the alveolar level and why surfactant loss changes everything How inflammation leads to stiff lungs, poor compliance, and refractory hypoxemia Why lung-protective ventilation is about avoiding harm , not chasing perfect numbers Moving beyond tidal volume: how driving pressure reframes vent management How RTs use compliance trends to judge whether lungs are improving or failing PEEP selection: why tables are a guide, not…
People in this episode
Host: Sarah Lorenzini
Guest: Melody Bishop
Topics covered
- ARDS management
- ventilator strategies
- lung protection
- critical care
- respiratory therapy
- physiology
Keywords
- ARDS
- ventilation
- pulmonary edema
- refractory hypoxemia
- lung compliance
- PEEP selection
- proning
- recruitment maneuvers
Mentioned in this episode
Organizations: ARDS, RT
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