Huh 2009.

Methods	Prospective, single‐centre, parallel‐group RCT
Participants	n = 57. Inclusion criteria: ARDS, PaO2/FiO2 < 200 in Korea and Seoul
Interventions	Treatment: extended sigh method of recruitment manoeuvre to peak of 55 cm H2O airway pressure and VCV with VT decreased by 25% from baseline, performed daily for 7 days. PCV, VT = 6 mL/kg, optimal PEEP setting determined during decremental PEEP titration. RM was also performed after oxygen desaturation or circuit disconnection. Control: ARDSNet protocol, with table‐based FiO2/PEEP strategy, PCV, VT = 6 mL/kg
Outcomes	Primary: oxygenation measured with PaO2/FiO2 daily for 7 days Secondary: PEEP and dynamic compliance (daily for 7 days), ICU LOS, duration of sedatives and paralysing agents, duration of MV, 28‐day mortality, 60‐day mortality and 90‐day mortality
Notes	Exclusion criteria not clearly stated, but 4 participants with fulminant hepatitis or terminal cancer were excluded. Contacted study author directly by email for additional details and received a response on 19.03.2015
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Use of a randomization scheme
Allocation concealment (selection bias)	Unclear risk	Not stated
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not stated
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Participant follow‐up was incomplete.
Selective reporting (reporting bias)	Unclear risk	4 participants who withdrew from the study were excluded from the analysis. It is unclear on what bases these participants were excluded.
Intention to treat	High risk	4 participants who withdrew from the study were excluded from the analysis. It is unclear on what bases these participants were excluded.