In patients with acute respiratory distress syndrome (ARDS), recruitment of collapsed lung units might decrease the risk of ventilator-induced lung injury, but the effect on mortality is not known. The Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial Investigators randomized 1010 patients with moderate to severe ARDS from 120 intensive care units and found that a treatment strategy of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs a conventional low-PEEP strategy increased 28-day all-cause mortality. In an Editorial, Sahetya and Brower suggest that allowing some lung units to remain closed may be less harmful than aggressive efforts to keep them open.
Highlights. JAMA. 2017;318(14):1297–1299. doi:10.1001/jama.2016.13344
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