Luca Salvatore Menga, Mayson L A Sousa, Nannan Sun, Rollin Roldán, Clément Brault, Mariangela Pellegrini, Matthew Ko, L. Felipe Damiani, Vorakamol Phoophiboon, S. Dubó, Fernando Vieira, Antenor Salzer Rodrigues, Mattia Docci, Lu Chen, Annia Schreiber, AS Slutsky, Martin Post, Laurent Brochard
Dorsal regions are more recruitable than ventral, decreasing their dynamic strain with PEEP, but relative PEEP effects vary across ARDS phenotypes with different global recruitability. The higher the global recruitability, the higher the effect on the dorsal part. This was demonstrated across two acute lung injury (ALI) animal models and two patient cohorts, mixed ARDS, and COVID-19 ARDS. PEEP can paradoxically increase dynamic dorsal strain despite recruitability if ventral overdistention occurs. EIT can detect this.