In patients with Acute Respiratory Distress Syndrome (ARDS), plateau pressure, driving pressure, and respiratory system compliance can be measured during assisted ventilation, and both higher driving pressure and lower compliance are associated with increased mortality.

In contrast to controlled mechanical ventilation, plateau pressure during assisted ventilation was higher than the sum of PEEP and pressure support (peak pressure).

Driving pressure was higher; compliance was lower; and peak pressure was similar, in nonsurvivors versus survivors.

Lower respiratory system compliance and higher driving pressure were each independently associated with increased risk of death.

This is a retrospective cohort study conducted on 154 patients with ARDS in whom plateau pressure during the first three days of assisted ventilation was available.

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