Table 1 Summary of the three clinical trials evaluating “lower or higher PEEP” setting
From: How we approach titrating PEEP in patients with acute hypoxemic failure
Trial | N | Patients | Lower PEEP | Higher PEEP | Primary outcome |
|---|---|---|---|---|---|
Alveoli [5] | 549* | Early ARDS, Pao2/FiO2 < 300mmHg, inclusion within 36 h of meeting eligibility criteria | Low PEEP/Fi,O2 table | High PEEP/Fi,O2 table | Proportion of patients who died before they were discharged home while breathing without assistance was not different between groups (25% vs 28%) |
LOV [13] | 983 | Early ARDS, Pa,O2/Fi,O2 < 250mmHg, inclusion within 48 h of meeting eligibility criteria | Lower PEEP/Fio2 table | High PEEP/Fi,O2 table. Protocol modifications during trial | All-cause hospital mortality was not different between groups (40% vs 35%) |
Express [8] | 767 | Early ARDS, Pa,O2/Fi,O2 < 300mmHg, inclusion within 48 h of meeting eligibility criteria | PEEP between 5 and 9 cmH2O | As high as possible while maintaining Pplat < 30cmH2O | 28-day motility was not different between groups (31% vs 28%) |