EPVENT2

2019 Respiratory
? ICUs
200 patients

The use of TPP to titrate PEEP did not improve outcomes in ARDS.

Clinical Question

Does titrating positive end-expiratory pressure (PEEP) with the use of an
esophageal balloon to estimate pleural pressure improve outcomes compared
with an empirical high PEEP –FiO2 strategy in patients with moderate –
severe acute respiratory distress syndrome (ARDS)

Critical Appraisal

Weaknesses

Unusual standard of care

Critique

Usual care of ARDS was not typical - aggresive PEEP/FiO2 table, low utilization of proning

Population
ARDS
Population Details
PaO2/FiO2 < 200
Intervention Arms

Transpulmonary Pressure
Transpulmonary pressure to titrate PEEP

Control Arms

ARDSnet protocol

Primary Outcome
Composite mortality and ventilator free days
Secondary Outcomes
No difference in mortality , No difference in ventilator free days
P Value
0.92

Outcome Results

Not recorded