Ultra-protective vs. Standard Ventilation Strategy in Moderate to Severe Acute Respiratory Distress Syndrome: A Systematic Review of Survival and Complications

This systematic review analyzes the efficacy and safety of ultra-protective ventilation (Tidal Volume < 6 mL/kg or driving pressure-limiting strategies) compared to standard protective ventilation (6 mL/kg) in critically ill adults with moderate to severe ARDS. Based on recent trials (REST, VT4COVID, STAMINA), the study investigates whether further reduction in lung stress impacts 90-day mortality and the incidence of adverse events like respiratory acidosis and intracranial hemorrhage.