Respiratory failure & ventilation
Influence of respiratory mechanics, lung recruitability and hemodynamics on pulmonary and extrapulmonary effects of positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS) patients: a prospective observational study
Authors' conclusion
Although increasing PEEP from 5 to 15 cmH2O improved oxygenation, it reduced cardiac output and diuresis independently of elastance transmission ratio and lung recruitability.
Study context
- Population
- Deeply sedated, paralyzed, mechanically ventilated ARDS patients within the first 48 hours from ICU admission
- Participants
- 38 participants
- Exposure
- PEEP 15 vs 5 cmH2O
- Outcome
- PaO2/FiO2
Methodological detailscrossover of PEEP levels within patients
- Crossover of PEEP levels within patients
Main finding
As reported in the abstract
PEEP 5
123
range 88–153
PEEP 15
189
range 117–219
P < 0.001
Observational data: associations, not effects.
Further findings
Venous admixture
P < 0.001
Subgroups by lung-chest wall transmission ratio or recruitability (subgroup)
- Similar changes in respiratory mechanics, gas exchange, hemodynamics, and urine variables
Subgroup by CO at 5 cmH2O PEEP (subgroup)
- Higher baseline CO: lower oxygenation and greater reduction in CO with high PEEP
- Urinary output changes similar regardless of baseline CO
Safety
Cardiac output
P < 0.001
Urine output
P = 0.011
Original publication
Influence of respiratory mechanics, lung recruitability and hemodynamics on pulmonary and extrapulmonary effects of PEEP in ARDS patients: a prospective observational study. Anaesth Crit Care Pain Med. Published 22 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →