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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. 3 — Effect of modifying PEEP on respiratory effort and lung-distending pressure. There was no difference in ∆Pes, ∆P_L,dyn, or the probability of meeting lung- and diaphragm-protective targets between higher or lower PEEP levels (A, B). The effects of higher vs. lower PEEP on ΔPes and ΔP_L,dyn, varied widely between patients according to the effect of changing PEEP on dynamic lung compliance (C). The probability of meeting LDP targets at the PEEP level associated with higher dynamic lung compliance was greater in comparison to the PEEP level associated with lower dynamic lung compliance (D). Error bars represent 25^th and 75^th percentiles with median (circle). LDP: lung and diaphragm protection, ∆Pes: esophageal pressure swing, ∆P_L,dyn: dynamic transpulmonary driving pressure, C_L,dyn: dynamic lung compliance, PEEP: positive end-expiratory pressure