Association of Positive End-Expiratory Pressure and Lung Recruitment Selection Strategies with Mortality in Acute Respiratory Distress Syndrome: A Systematic Review and Network Meta-analysis

To compare the relative effects of different PEEP selection strategies on mortality in adults with moderate to severe ARDS. Compared with a higher PEEP without LRM strategy, the posterior probability of increased mortality from a higher PEEP with a prolonged LRM strategy was 99%. In patients with moderate to severe ARDS, higher PEEP without LRM is associated with a lower risk of death than lower PEEP. Conversely, a higher PEEP with a prolonged LRM strategy is associated with an increased risk of death than a higher PEEP without LRM.