Lung recruitability determines the impact of PEEP on mechanical power in ARDS
Absolute mechanical power increases with higher PEEP, but power per aerated lung decreases when PEEP produces substantial recruitment. PEEP-induced increases in absolute power do not necessarily imply a higher mechanical load per alveolar unit. Recruited volume and compliance changes are the main physiological determinants of this effect. Among bedside tools, the R/I ratio best identifies whether and to what extent PEEP will reduce or increase mechanical power per alveolar unit.
Authors
- Francesca Collino (ORCID: https://orcid.org/0000-0001-6434-2657)
- Luigi Camporota (ORCID: https://orcid.org/0000-0001-5600-1676)
- Mattia Busana (ORCID: https://orcid.org/0000-0002-1626-1278)
- Irene Steinberg (ORCID: https://orcid.org/0000-0002-9610-399X)
- Antonio Maria Dell’Anna (ORCID: https://orcid.org/0000-0002-8357-504X)
- Gabriele Pintaudi
- Massimo Antonelli
- Domenico L. Grieco
- Antonio Pesenti
Institutions
- Università Cattolica del Sacro Cuore (IT)
- Universidade Federal do Rio de Janeiro (BR)
- King's College London (GB)
- Guy's and St Thomas' NHS Foundation Trust (GB)
- Agostino Gemelli University Polyclinic (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Thomas Foundation (AU)
- Universitätsmedizin Göttingen (DE)
- Azienda USL di Bologna (IT)
- University of the Sacred Heart (JP)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- University of Turin (IT)
- University of Bologna (IT)
Publication Details
- Journal
- Critical Care
- Published
- 2026-01-20
- DOI
- https://doi.org/10.1186/s13054-026-05843-y
- Citations
- 1
- Primary Topic
- Respiratory Support and Mechanisms
- Type
- article
- Field-Weighted Citation Impact
- 36.44