Stability of Driving Pressure Changes During "Best Positive End Expiratory Pressure (PEEP)" Trial

Stability of Driving Pressure Changes During "Best Positive End Expiratory Pressure (PEEP)" Trial

The goal of this study is to better understand in changes in lung compliance as indicated by driving pressure (a non-invasive marker) following changes in positive end expiratory pressure (PEEP; a standard of care ventilator parameter).

The main question it aims to answer is: The time to stability of driving pressure after a change in PEEP is made Type of study: observational study participant population/health conditions

Participants will undergo a "best PEEP trial" which is a standard intensive care intervention for patients undergoing invasive mechanical ventilation. This involves changing the patient's PEEP and looking for response in driving pressure. This will be done in a more protocolized format and data will be collected.

Inclusion Criteria:

• Adult patients >18 years of age
• Undergoing intubation and mechanical ventilation in Medical Intensive Care Unit (MICU) or Medical Critical Care Unit (MCCU) at the University of Alabama Birmingham.

Exclusion Criteria:

• Prisoner
• Pregnant
• Age <18 years of age
• Intensive Care Unit (ICU) team declines participation
• Unstable oxygenation (requiring 100% FiO2 to maintain saturations greater than 90% oxygen saturation following initial PEEP titration by primary team)
• Hemodynamic instability: vasopressor requirement of >0.3 mcg/kg/min of norepinephrine or equivalent
• Pneumomediastinum
• Pneumothorax without chest tube
• Previous enrolled in trial
• Need for immediate travel out of ICU following intubation for procedures, tests