Fig. 1.

Standard protocol-based approach versus lung rescue team approach. According to the standard protocol-based approach, ARDS patients were essentially treated setting the mechanical ventilator in accordance with the indications provided by ARDSnet tables (panel 1). Conversely, an individualized lung rescue team approach (panel 2) involved a thorough (multidisciplinary) assessment of respiratory mechanics, including esophageal pressure monitoring (2, A), as well as the patient’s response to lung recruitment. The best-PEEP was titrated based on a decremental PEEP trial, while hemodynamics was assessed by means of transthoracic echocardiography (2, B). PEEP, positive end-expiratory pressure; F_iO₂, inspiratory fraction of oxygen; P_L, transpulmonary pressure