ALVEOLI

Higher versus Lower Positive End-Expiratory Pressures in ARDS

Patient / Population Intervention / Exposure Comparison Outcome

In 549 patients with ARDS, a higher PEEP strategy did not reduce in-hospital mortality compared with a lower PEEP strategy.

549

Design

Multicentre RCT

Endpoint

In-hospital mortality before discharge with unassisted breathing

Relevance

Result24.9% vs 27.5% (NS).

Brower RG, et al. N Engl J Med. 2004;351(4):327-336. 10.1056/NEJMoa032193

Discussion & critique

Routine high PEEP doesn't help unselected ARDS; later analyses suggest benefit in moderate–severe disease.