Global versus regional effects of PEEP on recruitment and strain: insights from preclinical and clinical studies
Year: 2026
Type: article
Abstract: 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.
Source: Journal of Applied Physiology
Authors: Luca Salvatore Menga, Mayson L. A. Sousa, Nannan Sun, Rollin Roldan, Clément Brault, Mariangela Pellegrini, Matthew Ko, L. Felipe Damiani, Vorakamol Phoophiboon, Sebastian Dubo, Fernando Vieira, Antenor Rodrigues, Mattia Docci, Lu Chen, Annia Schreiber, Arthur S. Slutsky, Martin Post, Laurent Brochard
Institutions: St. Michael's Hospital, University of Toronto, Great Ormond Street Hospital, Hospital for Sick Children, Unity Health Toronto, University of Manitoba, Shandong Provincial QianFoShan Hospital, Shandong First Medical University, University of Piura, Centre Hospitalier Universitaire Amiens-Picardie, Uppsala University, Pontificia Universidad Católica de Chile, Chulalongkorn University, University of Concepción, Université Laval
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G6993735085, G8369569319
OpenAlex ID: W7128017153