Respiratory failure & ventilation
Driving pressure vs. oxygenation-based PEEP titration strategies in ARDS patients: a physiological study
Authors' conclusion
Clinical PEEP titration provided better respiratory mechanics in terms of lower end-inspiratory airway pressure, lung stress and elastance and lower PaCO2 compared with a high PEEP/FiO2 table.
Study context
- Population
- Sedated, paralysed, mechanically ventilated patients with ARDS (Berlin definition) within 48 h from admission to a medical-surgical ICU
- Participants
- 35 participants
- Exposure
- Clinical vs empirical vs fixed PEEP titration
- Outcome
- Gas exchange, partitioned respiratory mechanics and mechanical power during protective lung ventilation
- Follow-up
- After 20 min of each phase
Methodological detailsphysiological study, crossover of three PEEP titration strategies within each patient
- Physiological study
- Crossover of three PEEP titration strategies within each patient
Main finding
As reported in the abstract
Whole population: empirical vs clinical PEEP
Observational data: associations, not effects.
Further findings
Mild-moderate ARDS (subgroup) · values are PEEP levels
| Outcome | Clinical | Empirical | Fixed |
|---|---|---|---|
| Moderate-severe ARDS (subgroup)Values are PEEP levels | — not stated in the abstract | 17 (IQR 14–18) cmH2O | 15 cmH2O |
— not stated in the abstract
Mild-moderate ARDS (subgroup)
- End-inspiratory airway pressure and lung stress significantly higher with clinical and empirical vs fixed PEEP
- Mechanical power higher with empirical PEEP vs other strategies
- Gas exchange did not differ
Moderate-severe ARDS (subgroup)
- End-inspiratory airway pressure, lung stress, mechanical power, PaO2/FiO2 and PaCO2 significantly higher with fixed and empirical vs clinical PEEP
Original publication
Driving pressure vs. oxygenation-based PEEP titration strategies in ARDS patients: a physiological study. Crit Care. Published 8 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →