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.
Sklar MC, Goligher EC. Strategies to Adjust Positive End-Expiratory Pressure in Patients With ARDS. JAMA. 2019;322(6):580–582. doi:10.1001/jama.2019.7880
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