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OBJECTIVE To analyze the application of functional residual capacity (FRC)-guided optimal positive end-expiratory pressure (PEEP) in pulmonary retention in patients with acute respiratory distress syndrome (ARDS), and to explore the correlation between FRC and trans-pulmonary pressure and their predictive value for prognosis. METHODS Seventy-eight ARDS patients on mechanical ventilation admitted to department of critical care medicine of the First Affiliated Hospital of Jinzhou Medical University from March 2018 to May 2019 were enroll