What question did this study set out to answer?

The aim is to understand how lung recruitability impacts the relationship between PEEP and mechanical power in ARDS patients.

January 22, 2026Open Access

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Lung recruitability determines the impact of PEEP on mechanical power in ARDS

DGDomenico L. GriecoUniversità Cattolica del Sacro Cuore FCFrancesca CollinoAzienda Ospedaliera Citta' della Salute e della Scienza di Torino ISIrene SteinbergMeyer Children's Hospital

Key Points

The aim is to understand how lung recruitability impacts the relationship between PEEP and mechanical power in ARDS patients.
Assessment of changes in mechanical power with varying levels of PEEP.
Evaluation of recruitment volume and compliance changes.
Use of the R/I ratio to analyze PEEP's effects on mechanical power.
Absolute mechanical power increases with higher PEEP levels.
Mechanical power per aerated lung decreases when significant recruitment occurs.
R/I ratio effectively identifies the potential changes in mechanical power per alveolar unit.

Abstract

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.

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Lung recruitability determines the impact of PEEP on mechanical power in ARDS

Key Points

Abstract

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