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The aim of this prospective longitudinal study was to compare driving pressure and absolute PaO /FiO ratio in determining the best positive end-expiratory pressure (PEEP) level. In 122 patients with acute respiratory distress syndrome, PEEP was increased until plateau pressure reached 30 cmH O at constant tidal volume, then decreased at 15-min intervals, to 15, 10, and 5 cmH O. The best PEEP by PaO /FiO ratio (PEEP ) was defined as the highest PaO /FiO ratio obtained, and the best PEEP by driving pressure (PEEP ) as the lowest driving p
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