What PEEP/FiO2 combinations are used in ARDSnet protocols?

ARDSnet lower PEEP table: FiO2 0.3-0.4/PEEP 5; 0.4/PEEP 8; 0.5/PEEP 10; 0.6/PEEP 10; 0.7/PEEP 10; 0.7-0.8/PEEP 12; 0.8-1.0/PEEP 14; 0.9/PEEP 16; 1.0/PEEP 18-24. Higher PEEP table (ART trial): higher PEEP for P/F <200, titrated to plateau pressure <=28 cmH2O.

Should PEEP be titrated by driving pressure?

Driving pressure optimization is gaining adoption: set PEEP at the level minimizing driving pressure (plateau pressure minus PEEP). Lower driving pressure is independently associated with survival in ARDS. Esophageal pressure monitoring (estimates transpulmonary pressure) allows individualized PEEP titration but is not standard practice in most ICUs.

PEEP Setting by ARDS Severity Calculator

Determine optimal PEEP setting for ARDS using ARDSnet PEEP/FiO2 tables (lower vs higher PEEP strategy) based on P/F ratio severity and lung recruitability assessment.

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Frequently Asked Questions

What PEEP/FiO2 combinations are used in ARDSnet protocols?

Should PEEP be titrated by driving pressure?