Personalized Mechanical Ventilation Guided by UltraSound in Patients With Acute Respiratory Distress Syndrome

"Patients who are randomized for personalized ventilation with FOCAL ARDS will receive the following ventilator settings:~* Positive end-expiratory pressure (PEEP) ≤ 9 cm water (H2O)~* Tidal volume: 6 to 8 mL/kg predicted body weight (PBW)~* Daily prone positioning~LUS will be repeated every 48-72 hours in supine position for the focal ARDS patients to assess whether they have developed non-focal ARDS during admission. In that case, patients will from then on be treated according non-focal personalized treatment protocol.~Patients who are randomized for personalized ventilation with Non-FOCAL ARDS will receive the following ventilator settings:~* PEEP ≥ 15 cm H2O~* Tidal volume: 4 to 6 mL/kg PBW~* Daily recruitment maneuver"

"Patient who are randomized in the control group will receive standard care~* Tidal volume: 6 mL/kg PBW~* PEEP and FiO2 according to the low PEEP and high fraction of inspired oxygen (FiO2) table of the AlVEOLI study~* Prone positioning if the Partial Pressure of Oxygen (PaO2) /FiO2 ratio is \< 150 mmHg"