Driving Pressure and Respiratory Mechanics in ARDS

In this issue of the Journal, Amato et al.1 use data from previously published trials to determine whether it is possible to predict outcomes in patients with the acute respiratory distress syndrome (ARDS) on the basis of the settings of their mechanical ventilators or parameters derived from monitoring the mechanics of the ventilation achieved. Previous articles published in the Journal had shown that a lung-protective strategy — that is, limiting the tidal volume (Vt) and plateau pressure while providing relatively high positive end-expiratory pressure (PEEP), can improve survival in ARDS,2,3 thus demonstrating the importance of respiratory mechanics . . .