Use of the restricted PEEP level (0 - 5 cm H2O, the lowest possible PEEP level) after intubation and during all mechanical ventilation.

Use of the liberal PEEP level (8 cm H2O) after intubation and during all mechanical ventilation.

Ventilator-free Days

Patients are randomized and ventilated with restricted PEEP (the lowest possible PEEP level, 0 - 5 cm H2O)

restricted PEEP

Patients are randomized and ventilated with liberal PEEP (the median PEEP level used in the Netherlands, 8 cm H2O)

liberal PEEP

RELAx website, link to the study protocol

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Onze Lieve Vrouwe Gasthuis

VU Medical Center

Gelre Hospital

Rijnstate

Amphia Hospital

Spaarne Gasthuis

Westfriesgasthuis

Maastricht University Medical Center

Sint Antonius Hospital

Haaglanden Medical Center

HagaZiekenhuis

Isala Clinics

REstricted Versus Liberal Positive End-Expiratory Pressure in Patients Without ARDS

REstricted Versus Liberal Positive End-Expiratory Pressure in Patients Without Acute Respiratory Distress Syndrome

The number of ventilation-free days, defined as the number of days from day 1 to day 28; the patient is alive and breathes without assistance of the mechanical ventilator, if the period of unassisted breathing lasted at least 24 consecutive hours.

Length of stay in the intensive care unit and in the hospital

Any death during ICU-, hospital-stay and within 90 days

development of ARDS according tot the Berlin definition, severe hypoxemia, severe atelectasis, severe atelectasis, pneumonia and pneumothorax.

Recruitment maneuver, prone positioning and bronchoscopy for opening atelectasis.

The number of ICU days with any use of vasopressors/inotropes for > 2 hours on a day.

Defined as the number of ICU days with any use of sedatives for > 2 hours on a day.

Incremental Cost Effectiveness Ratios (ICER) will be calculated by extra costs per TISS/NAS point, a valuable score reflecting workload and resource utilization in daily ICU practice.

fasciitis/hypoxia

REstricted Versus Liberal Positive End-Expiratory Pressure in Patients Without ARDS

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