Respiratory failure & ventilation
Comparison of positive end-expiratory pressure (PEEP) tables based on oxygenation vs. driving pressure-guided PEEP titration in patients with severe acute respiratory syndrome due to COVID-19
Authors' conclusion
The PEEP by titration based on ΔP was similar to the ARDSnet low PEEP table, both being different from the other tables. In obese patients, the PEEP found by titration was significantly different in all methods evaluated in this study.
Study context
- Population
- Adults with SARS due to COVID-19 (CARDS), academic ICU in Brazil141 titrations
- Participants
- 91 adults
- Exposure
- Best-ΔP decremental PEEP titration vs PEEP-FiO2 tables
- Outcome
- PEEP values by Best-ΔP titration vs PEEP-FiO2 tables
Methodological detailssingle-centre, academic ICU, Median PaO2/FiO2 133 (97-170)
- Single-centre
- Academic ICU
- Median PaO2/FiO2 133 (97-170)
Main finding
As reported in the abstract
PEEP value
- Best-ΔP vs ARDSnet: P = 0.83
- Best-ΔP vs LOVs: P < 0.001
- Best-ΔP vs ALVEOLI: P < 0.001
Observational data: associations, not effects.
Further findings
PEEP value, body mass index (BMI) > 30 kg/m² (subgroup)
- Different in all FiO2-tables and best ΔP (n = 73)
- P < 0.001
Original publication
Comparison of PEEP tables based on oxygenation vs. driving pressure-guided PEEP titration in patients with severe acute respiratory syndrome due to COVID-19. J Crit Care. Published 23 June 2025. doi:10.
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