High levels of PEEP are not better than low levels for reducing mortality in adult ICU patients with acute respiratory distress syndrome (ARDS) or acute lung injury (ALI)

Added March 18, 2020

Citation: Santa Cruz R, Rojas JI, Nervi R, et al. High versus low positive end-expiratory pressure (PEEP) levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome. Cochrane Database of Systematic Reviews 2013; (6): CD009098

What is this? Some patients with COVID-19 will develop acute respiratory distress syndrome (ARDS) or acute lung injury (ALI) and need help with their breathing. This might be provided by mechanical ventilation (MV) in an intensive care unit (ICU).  High levels of positive end-expiratory pressure (PEEP) might be used to prevent lung damage during MV.

In this Cochrane systematic review, the authors searched for randomized trials to assess the effects of high versus low levels of PEEP in patients with ARDS or ALI. They did not restrict by language of publication and did their searches in May 2013. They identified 7 randomized trials (2565 participants).

What works: Nothing noted.

What doesn’t work: High levels of PEEP were not found to reduce hospital mortality compared to low levels in patients with ARDS or ALI.

What’s uncertain: Nothing noted.


Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.