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Table 2 Summary of mechanical ventilation procedures in the ART strategy group vs. ARDSNet strategy group

From: Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Procedure ART strategy: maximum alveolar recruitment maneuver associated with PEEP titration ARDSNet strategy
Alveolar recruitment maneuver Yes (see Figure1) No
Ventilation mode Volume-controlled Volume-controlled
Target plateau pressure and driving pressure Plateau ≤30 cmH2O Plateau ≤30 cmH2O
Target tidal volume 4 to 6 mL/kg of predicted body weight 4 to 6 mL/kg of predicted body weight
Respiratory rate and pH goal 6 to 35/min, adjusted for pH ≥ 7.30 if possible 6 to 35/min, adjusted for pH ≥ 7.30 if possible
I:E ratio 1:1 to 1:2; flow 60 L/min; inspiratory pause 0.5 s 1:1 to 1:2; flow 60 L/min; inspiratory pause 0.5 s
Oxygenation goals   
 PaO2 60 to 80 mmHg 55 to 80 mmHg
 SpO2 90 to 95% 88 to 95%
PEEP and FiO2 adjustment PEEP titration 2 cmH2O above PEEP value associated with maximum compliance. FiO2 titration adjusted according to oxygenation goals According to PEEP/FiO2 combination table
Weaning After 24 h with PaO2/FiO2 ≥ 300 (or stable/ascending) start weaning from PEEP 2 cmH2O every 8 h. Consider pressure support ventilation after PEEP ≤ 14 cmH2O. Spontaneous ventilation test in PS = 5 cmH2O and PEEP = 5 cmH2O. Routine use of NIV immediately after extubation is encouraged Weaning from PEEP according to table of PEEP and FiO2 combinations. Consider pressure support ventilation after PEEP ≤ 14 cmH2O. Spontaneous ventilation test in PS = 5 cmH2O and PEEP = 5 cmH2O. Routine use of NIV immediately after extubation is encouraged