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. 2022 Aug 29;26:259. doi: 10.1186/s13054-022-04123-9

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — Trial design. A Study procedure to test the effect of different interventions on the probability of achieving lung- and diaphragm-protective targets. B Approach to adjusting ventilation and sedation to achieve lung- and diaphragm-protective targets. The algorithm used for titration in the trial is provided in Additional file 1: Fig. S2. PEEP: positive end-expiratory pressure; VV-ECMO: veno-venous extracorporeal membrane oxygenation; LDP: lung- and diaphragm-protective; ∆Pes: esophageal pressure swing; ∆P_L,dyn: dynamic driving transpulmonary pressure