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Comment & Response
August 13, 2019

Strategies to Adjust Positive End-Expiratory Pressure in Patients With ARDS

Author Affiliations
  • 1Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
JAMA. 2019;322(6):580-582. doi:10.1001/jama.2019.7880

To the Editor Dr Beitler and colleagues for the EPVent-2 Study Group conducted a randomized clinical trial of titrating positive end-expiratory pressure (PEEP) according to end-expiratory pleural pressure estimated from esophageal pressure (PES) in patients with acute respiratory distress syndrome (ARDS).1 The PES approach studied was compelling as a means of individualizing PEEP according to chest wall mechanics. While the results are disappointing, we argue that they are not altogether surprising.