Respiratory failure & ventilation
Impact of higher versus lower positive end-expiratory pressure (PEEP) on mortality in mechanically ventilated patients with Sepsis — A multicenter, multi-cohort observational analysis
Authors' conclusion
In this multi-cohort analysis, higher PEEP (above ARDSnet low PEEP table) was associated with improved survival without evidence of hemodynamic deterioration.
Study context
- Population
- Septic patients requiring mechanical ventilation in three cohorts (Hyspec ICU, SepDataNet, RetroSep)
- Participants
- 844 patients · 3 cohorts
- Exposure
- Higher PEEP vs lower PEEP
- Outcome
- ICU or 30-day mortality depending on reported outcome data
Methodological detailssecondary analysis of three cohorts, multicentre, multi-cohort, propensity-score matched (RetroSep)
- Secondary analysis of three cohorts
- Multicentre
- Multi-cohort
- Propensity-score matched (RetroSep)
Main finding
As reported in the abstract
RetroSep, ICU mortality: High PEEP vs Low PEEP
39.4% vs. 50.4%
p = 0.008
Hyspec-ICU, 30-day mortality: High PEEP vs Low PEEP
22% vs. 41.7%
p = 0.029
Observational data: associations, not effects.
Secondary outcomes
ICU mortality, RetroSep cohort after propensity score matching
- Difference persisted after propensity score matching (higher vs lower PEEP)
- 38.4% vs. 49.4%; p = 0.046
- Propensity score matched
Hemodynamic parameters (lactate, vasoactive-inotropic scores)
- Similar or improved in high PEEP groups
Original publication
Impact of higher versus lower PEEP on mortality in mechanically ventilated patients with Sepsis — A multicenter, multi-cohort observational analysis. J Crit Care. Published 4 June 2026. doi:10.
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