Association of different positive end-expiratory pressure selection strategies with all-cause mortality in adult patients with acute respiratory distress syndrome

Table 1 Different available positive-end-expiratory pressure (PEEP) titration strategies for adult patients with acute respiratory distress syndrome

Strategy	Landmark study	Description
Low PEEP:FiO₂ table	Brower, 2004 Meade, 2008	PEEP depends on level of required oxygenation (i.e., 10 cmH₂O for a required FiO₂ = 60%)^a
High PEEP:FiO₂ table	Brower, 2004	PEEP depends on level of required oxygenation (i.e., 16 cmH₂O for a required FiO₂ = 40%)
Higher PEEP based on lung mechanics	Mercat, 2008 Pintado, 2013 Salem, 2020	PEEP depends on a specific measure: - Plateau pressure < 30 cmH₂O - Highest static compliance - PEEP depends on the classification of patients using lung ultrasound
PEEP titration based on esophageal manometry	Talmor, 2008 Beitler, 2019	PEEP depends on the transpulmonary pressure measured by esophageal manometry
PEEP titration following a recruitment maneuver^b	Meade, 2008 Cavalcanti, 2017	PEEP titration (either based on FiO₂ or lung mechanics) following a recruitment maneuver

^aThis arm will also include low PEEP strategies without a specific PEEP:FiO₂ table such in Mercat 2008
^bDifferent recruitment maneuvers will be considered (e.g., brief maneuvers including higher pressures for less than 60 s vs. the use of staircase maneuvers)

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