Respiratory failure & ventilation
Lung recruitability determines the impact of positive end-expiratory pressure (PEEP) on mechanical power in ARDS
Authors' conclusion
Absolute mechanical power increases with higher PEEP, but power per aerated lung decreases when PEEP produces substantial recruitment.
Study context
- Population
- Patients with ARDS undergoing a decremental PEEP trial
- Participants
- 20 patients
- Comparison
- Higher vs lower lung recruitability
- Primary endpoint
- Change in absolute mechanical power and power normalized to aerated lung volume (FRC + recruited volume) with PEEP
Methodological detailsmechanistic study, decremental PEEP trial (15-5 cmH₂O)
- Mechanistic study
- Decremental PEEP trial (15-5 cmH₂O)
Primary result
As reported in the abstract
Mechanical power vs PEEP
| Group | Absolute power slope | Normalized power slope |
|---|---|---|
| Low recruitability | + 1.12 J/min per cmH₂O, p < 0.001 | + 0.43 J/min/L per cmH2O, p < 0.001 |
| High recruitability | + 0.96 J/min per cmH₂O, p < 0.001 | - 0.33 J/min/L per cmH2O, p < 0.001 |
Absolute power slope
Low recruitability+ 1.12 J/min per cmH₂O, p < 0.001
High recruitability+ 0.96 J/min per cmH₂O, p < 0.001
Normalized power slope
Low recruitability+ 0.43 J/min/L per cmH2O, p < 0.001
High recruitability- 0.33 J/min/L per cmH2O, p < 0.001
- Absolute power, all patients, PEEP 5 cmH₂O
- 20 [16-23] J/min
- Absolute power, all patients, PEEP 15 cmH₂O
- 31 [28-33] J/min
- Absolute power increase approximately linear
- + 1 J/min per cmH₂O
Further findings
Determinants of reduction in normalized power
- Recruited volume/functional residual capacity (FRC)
- - 102% per unit, R2 = 0.75, p < 0.001
- R/I ratio
- - 38% per unit, R2 = 0.69, p < 0.001
- PEEP-related compliance change
- R2 = 0.40, p = 0.003
- PaO₂/FiO₂ change
- R2 = 0.33, p = 0.008
Multivariate model, independent predictors of normalized power change
- PEEP-induced recruitment
- P = 0.002
- Compliance changes
- P = 0.011
Original publication
Lung recruitability determines the impact of PEEP on mechanical power in ARDS. Crit Care. Published 20 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →